Challenge and Change

Transcription

17-5/16 IN. TOTAL TRIM WIDTH
MAGENTA LINES FOR ART POSITIONING ONLY - DO NOT PRINT
THE HISTORY OF DANBURY HOSPITAL
1885
•
2010
10 IN
TRIM
HEIGHT
1885•2010
8-1/2 IN BACK
5/16 IN SPINE
C. D. Peterson
8-1/2 IN FRONT
1 8 8 5 •2 0 1 0
C. D. Peterson
To the People of Danbury Hospital
and the Patients They Serve
Proceeds for the sale of this book will benefit
the Danbury Hospital development fund.
© Copyright 2009 Danbury Hospital
All rights reserved. No part of this book may be reproduced, scanned,
or distributed in print or electronic form without permission. All images
in this book have been reproduced with knowledge and prior consent and
no responsibility is accepted by the producer, publisher, or printer of any
infringement of copyright or otherwise, arising from the contents of
this publication. Every effort has been made to ensure that credits
accurately comply with information supplied.
Design:
Stephen Roth, Roth Graphics
Printing:
Imperial Graphics, Stratford, CT
Paperback
ISBN 978-0-615-31049-7
Hardcover
ISBN 978-0-615-29493-3
v
Acknowledgments
T
his book presents a story rather than an academic resource and provides only practical annotation. Those seeking further details of dates, sources, and verbatim
materials can find them easily in the Danbury Public Library, The Danbury Museum
and Historical Society, and most importantly, in the Horblit Health Sciences Library
at Danbury Hospital. Those who want the very latest information about the hospital can
visit www.danburyhospital.org.
The Danbury Public Library offers a quiet room for this type of study. Excellent resources
include 19th century newspaper publisher James M. Bailey’s compiled columns and studies,
especially “Life in Danbury.”
The Danbury Museum and Historical Society supplied some of the exquisite photos and
background material on Danbury’s history. The society’s director, Brigid Guertin, will extend full cooperation to people seeking to learn about the region’s history.
Most of the material for this book came from the archives of Danbury Hospital’s Horblit
Health Sciences Library. My thanks to Amanda Pomeroy, the library’s director. I owe a very
special thanks to Mary Shah who helped me find numerous needles in haystacks, scanned
countless photos, and offered encouragement. The archives contain the actual annual reports
for all but a few years of the hospital’s history. Those and the very detailed medical staff reports
provided much of the factual material used here. Some of the numerical data contains gaps and
the record keeping methods changed over the years, but important trends and frames of reference
can clearly be seen. The archives also hold a treasure trove of photographs, clippings, meeting
minutes, architectural renderings, and other memorabilia. I commend the Horblit Health
Sciences Library to anyone interested in further exploration of Danbury Hospital’s history.
While many photos are from archives, the book benefits from the recent and very professional
photos taken by Wendy Carlson, Richard Freeda, and Dean Tozzoli.
continued on next page
vii
Interviews with dozens of doctors, nurses, and administrators provided the other major
source of material. The list of the people interviewed will follow these acknowledgments. Those
interviewed, without exception, conveyed a deep passion for Danbury Hospital and for its position
in the community. Their comments were always interesting, often colorful and occasionally
contradictory. In the end, the physical limits of this book would not allow for reproducing those
interviews but they are preserved on tape and notes, as part of the Horblit Health Sciences Library’s
oral history project, which is under Mary Shah’s direction. My thanks to the many others who
enthusiastically provided photos, memorabilia, ideas and insights, especially Sylvia McKean.
Paul Steinmetz lent his practiced literary skills to editing the copy. The designer of the book,
Stephen Roth of Roth Graphics, labored for months devising creative visual solutions to the
salmagundi of fragmented content, old clippings, sketchy graphics, quotes, and faded photos.
I offer a special thank you to Frank Kelly, president and CEO of Danbury Hospital, for giving
me this most enjoyable opportunity to develop the book and for his guidance and support.
The Interview Participants:
Joseph Belsky, M.D.
Henry Blansfield, M.D.
John C. Creasy, Former President
Thomas Draper, M.D.
Jack S.C. Fong, M.D.
Robert Fornshell, M.D.
Nelson Gelfman, M.D.
William Goldstein, M.D.
Robert Grossman, M.D.
John Hoffer, Former President of
Danbury Hospital’s Development Fund
Philip Kotch, M.D.
Matthew Miller, M.D. Vice President of Medical Affairs
John Murphy, M.D. Executive Vice President
viii
Peter Pratt, M.D.
Gerard D. Robilotti, Former President
Raphael Schwartz, M.D.
Nathaniel Selleck, M.D.
The Nurses Roundtable:
Elizabeth Ann Ballard, R.N.
Catherine Ann D’Aquila, R.N.
Franise Eng, R.N.
Patricia Macchiaverna, R.N.
Ethel Omasta, R.N.
Eleanor Rafferty, R.N.
Phyllis Tallman, R.N.
Joan Thorburn, R.N.
C. D. Peterson / 2009
Table of Contents
Introduction
1
Chapter 1
From Its Beginning to Its First Brick Building
2
25 Years Later
1885-1910
Chapter 2
The Young Twentieth Century
Revolutions, Wars and Epidemics
1910-1920
18
Chapter 3
From the Roaring Twenties
Through the Great Depression
1920-1940
28
Chapter 4
Through the War Years
1940-1950
38
Chapter 5
Dark Clouds to Blue Skies
1950-1960
46
Chapter 6
Challenge and Change Accelerated
1960-1970
58
Chapter 7
The Modern Hospital Takes Shape
1970-1980
72
Chapter 8
New Complexity – New Challenges
1980-1990
82
Chapter 9
“ . . . In Partnership with Those We Serve”
1990-2000
92
Chapter 10
The New Millennium – A New Model of Care
2000-Today
108
Post Script
A Look Ahead
128
Appendix I. Facts – Accolades – Awards
II.
Historic Timeline
III.
People in History
IV.
Residency Programs
V.Certifications
VI.
Satellite Locations
VII. Facilities History
137
138
142
146
147
148
150
ix
x
Introduction
S
ince the very beginning, Danbury Hospital’s history carries the message of challenge and change. From the first challenge issued by a group of women who drew the
attention of the community to the need for a hospital, right up to today’s challenge of dizzying
medical advances and burgeoning healthcare costs, Danbury Hospital has faced challenges and
changed to meet them.
Because of the unique way the hospital was formed, and perhaps because of the unique
character of the population it serves, Danbury Hospital has always met these challenges through
a three-part alloy of people from the community, the hospital, and the medical staff. Readers will
learn that this three-way partnership endured rocky times. Finances were sometimes strained.
Controversy erupted, most notably in the 1950’s. In recent times the challenges have included
struggles with government regulations, legal battles, and such momentous changes as Medicare,
the HMOs of managed care and now a financial crisis.
The rapid growth of medical technologies, procedures, equipment and new drugs now fosters
ever more precise specialization and complexity in the Hospital’s operations. Responding to the
challenge to stay at the forefront of medicine, the Hospital has become a full academic teaching
center. Choices about the allocation of limited resources will pose a growing challenge requiring
exceptional analysis and judgement. The growth of the hospital and its many facilities continues
to be a challenge both physically and financially.
The hospital has never been an institution unto itself. Here in the 21st century, 125 years after
the doors first opened, the same three-way partnership of the hospital, its medical staff, and the
people of the communities it serves continues to guide a strong Danbury Hospital.
By facing challenges and changing, Danbury Hospital has grown from two small cottages
to a sophisticated medical campus with locations throughout the region, proud of its national
recognition and award-winning Centers of Excellence. Its mission reflects its history and points
to its future, “to advance the health and well-being of the people in the community in partnership with
those we serve.”
1
Chapter 1
From Its Beginning to Its First
Brick Building 25 Years Later
1885-1910
2
A
long drama surrounded this short article reported in the Danbury News on March 20, 1885.
Dr. Alpheus E. Adams, believing a hospital was needed at this end of the county
(other than at Bridgeport), bought a piece of land and has built two cottages for hospital
buildings. He proposed to run the hospital at his own expense but later consideration
of the subject led him to believe that it would be better if the community establishment
was conducted by the people. And he proposed that the board of managers should
take and run this establishment. They could either purchase it on the street, or run
it for the space of one, two, or three years and then if they made a success of the
scheme, purchase.
There has been no further evidence substantiating the claim of Dr. Adams that he
built the houses with the hospital in mind.
Danbury had been without a hospital for 100 years 1 when Dr. Adams made his proposal to a prominent
group of local people, calling themselves the Hospital Society, that they should assume responsibility
for two buildings he had built on the hill on Crane Street.
The drama leading up to Dr. Adams’ proposal begins in the mid-1800s with the simultaneous rise of local
charitable societies and the developments in medical science.
Medical science uncovered the nature of bacteria, which led to the first attacks on infectious diseases.
Anesthesia was evolving. On Jan. 4 of 1885, the first successful appendectomy in the U.S. was performed.
Charity in the form of the Ladies Aid Society, St. Peter’s Benevolent Society, and many others in Danbury,
recognized the duty of providing assistance to the poor and needy. In reading the accounts of the formation
of the hospital committee, it is clear that the idea of a hospital came from the Victorian ideals of charitableminded citizens, not simply a desire to find a way to employ these latest medical advances.
1 Danbury’s very first hospital was built in 1775 on Park Avenue and Pleasant Street. Like many hospitals it was built in response to a war and closed soon after the Revolution in 1777.
FROM ITS BEGINNING TO ITS FIRST BRICK BUILDING 25 YEARS LATER, 1885-1910
3
A quilt made by the hat trimmers
at Beckerle & Company contains an
image, perhaps the only image, of the two
cottages that were truly the first hospital.
The quilt, which was raffled at the
Danbury Fair and raised $500 for the
new hospital, is owned by the Dorothy
Whitfield Historic Society in Wilford,
Conn. A history of the quilt and a color
photograph appear in the book Quilts
and Quiltmakers Covering.
4
The archives of the time describe how a group of women took the
initiative to enlist the aid of community leaders and doctors in order to
recommend to the public that a hospital be built. The records describe
another event soon after that involved the mailing of a card, authored by
eight physicians, to all the residents of Danbury.
“The physicians of Danbury appreciate the necessity of some suitable
place where the sick can be paid for and receive the comforts of home.
Believing that not only their comfort but their chances for recovery, also,
would be increased by such an institution, we cordially recommend the
establishment and maintenance of a home for the sick in the community.” 2
The first record of a meeting to discuss the need for a hospital shows
that in March of 1882 a gathering of what became known as the Hospital
Committee was held and participants described a hospital based on the
plan of a successful village hospital in England. At the time, Danbury
had a population of about 11,000 people, a population that would nearly
double by 1890.
Over the next few years, The Hospital Committee took on a formal
shape. Its written purpose was to organize an association “to establish
and maintain a hospital for the benefit of sick and injured
persons.” With a chairman and secretary appointed, the
committee prepared a constitution consisting of nine articles.
Although the document has been modified over the years, the
hospital today embodies the spirit of the original constitution.
In summary, the original articles provided as follows:
1. The organization was to be a Society called the Danbury
Hospital Association. It would provide care without regard
to race or religion to those who could not receive proper care
elsewhere.
2. Anyone could become a subscribing member of the
Society for the annual sum of at least one dollar.
3. Twelve members would govern the Society. This article
set their terms.
4. This important article declared that the Society would
not be managed to favor any one school of practice 3 over
another. All qualified physicians were eligible to practice at the hospital
and patients would choose the service of the physicians they desired.
5, 6, and 7. These articles established and set the responsibilities for the
Board of Managers, the treasurer and the auditor.
8. An annual meeting was set for March, when the Board of Managers
would make a report to the Society.
9. The process of constitutional amendment was described.
J. M. Bailey, Editor of the Danbury News
and a strong supporter of the hospital.
Danbury Museum and Historical Society.
Broad Resistance
From the beginning, the society’s idea faced opposition. The poor saw
the hospital as a step toward the grave while the rich were comfortable
receiving care in their homes. Some feared an overly grand undertaking
beyond the community’s needs and capabilities. Editorials and letters
flew. J. M. Bailey, the famous editor of the Danbury News, was a strong
supporter and used a propaganda device in his writing by always referring
to “the coming hospital,” which set off opponents.
The Society withstood the challenge. After reviewing several unsuitable
sites, the board of managers, following its purpose and exercising its
constitution, accepted Dr. Adams’ proposal and assumed responsibility for
the small, two-cottage hospital.
The generally recognized date of the opening of Danbury Hospital is
April 27, 1885. Incorporation followed in 1886.
2
3
The eight signers were Doctors E. P. Bennett,
W. C. Bennett, A.T. Clason, F. P. Clark, A. E. Adams,
W. F. Lacey, W. Bulkeley, and S. M. Griffin.
At the time, three schools of medicine were roughly described. One was the conventional school that used chemical medicines and surgery; one was homeopathic much like today, employing diluted compounds; and the third, called eclectic, was based on herbs and other natural cures.
5
A New Hospital –
Its First Challenge
V
ery quickly the hospital encountered a problem. As the Danbury News hinted in the last sentence of its article, Dr. Adams’ construction
of the two cottages was motivated by his noble impatience with the
community’s progress. However, his offer to have the society take over the
hospital appears to have resulted from his quick business sense that the two
small houses and the 15 beds were unsuitable for providing care acceptable
to patients and that it could not support itself financially.
The early expenses of the hospital were helped because Dr. Adams donated
the first year’s rent, but the hospital had no regular way to raise funds.
“Hospital Sunday” in local churches, proceeds from some of the activities
at the 16-year-old Danbury Fair, along with governmental and voluntary
contributions were expected to pay the bills. While originally intended for
patients with no means to obtain care otherwise, that intent dissolved.
That may explain why the Rules and Regulations of Danbury Hospital
of May 1885 state:
“The hospital is designed for paying and non paying patients.
Application for admission of patients must be made to the Committee for
Admissions. Consisting of: E. Barnum, E. Davis, Mrs. Ives, Mrs. Ryder
This is a copy of the $13,580 bid for
the new hospital by W. W. Sunderland
dated June 9, 1888.
Patients occupying private rooms will be charged from ten dollars upwards per
week.
The Horblit Health Sciences Library.
The ordinary charge in the wards will be from $4.50 upwards per week. This
includes board and nursing.
Non paying patients are received at the discretion of the Committee of
Admissions.
No person shall be admitted without a permit, except in the case of an accident,
and then only when brought directly from the place the accident occurred.
The Committee of Admissions shall determine whether the applicant for
admission shall be received free or pay and in the case of the latter shall
fix the rate of payment.
6
The two cottages did not seem to score well in terms of patient
satisfaction. Sketchy records show that in the first 12 months of operation,
up until April of 1886, the hospital treated only 87 patients. With 15 beds,
and if every patient had stayed 10 days, the hospital’s capacity would have
been more than 500 patients that first year.
Records show that in a matter of just a few months after the Board of
Mangers took over, they voted for the construction of a new hospital. The reason given was the need to build for the future. The town of
Danbury donated a parcel of land and the board assumed that all that
remained was to raise the money. Members sent a letter to the community
soliciting funds. They also applied for money from the state legislature and
received $6,000.
However, this swift re-approach to the community for a new hospital
met with some heated objection and criticism of the board. The board felt
a need to defend itself in the hospital’s second annual report in 1886. In it
members write, “We ask the public not to listen to the derogatory remarks
about the administration, but rather report them to the hospital. The
Board does not receive pay except reward for helping the sick. But we do not claim to be infallible.”
We don’t know if the board’s defense turned the tide, but the public’s
objections apparently dissolved and the hospital quickly raised $5,000.
The Mallory hat factory around 1884.
Hatting has always been a mixed
blessing for Danbury.
7
Wooster House at the corner of Main
and White Streets around the time
that Danbury recieved a bad health
report card.
The City Gets
A Bad Report Card
D
uring the time that the Board of Managers and others were pressing forward for the new hospital, the community received a startling
report from the state Board of Health describing the deplorable health and
sanitary conditions in the city.
The 1888 report cited high levels of pneumonia, diarrhea, typhoid and
diphtheria. In discussing small pox, it pointed to the fact that “vaccination
is not a condition of admission to schools.” The Danbury Times reported
that Danbury had the highest death rate of any town in the state that
summer. Of the 50 deaths, 33 were from infectious diseases.
The full report makes for dramatic reading and is available in the hospital
archives. It graphically portrays a Danbury polluted with sewage and
loaded with heaps of putrefying garbage.
Calculations showed that the flow of the Still River would not be
sufficient to cleanse itself. Dr. S. W. Williston wrote the report in an
openly scolding tone and made recommendations that Danbury grow up,
become a city, build a sanitation facility and institute garbage pick up.
An Incentive for Action
The report and the high rate of infectious diseases resulting from these
poor sanitary conditions most likely worked as an incentive to push
forward with a larger hospital.
8
By March of 1888 architectural sketches of the new 23-bed hospital
appeared in the newspapers.
An original budget of $12,000 was boosted to $16,000. By 1889, the
cost estimates were running as high as $34,000 and though fundraising
had been in place, the Board of Managers was forced to seek an additional
$8,000 from the state. Dr. Todd of Ridgefield, chairman of the state
Legislative Committee on Humane Institutions, visited Danbury and
toured the existing hospital. Dr. Todd may have been influenced by
the 1888 health report or by the progress Danbury was making in just
a year by transforming itself into a city and electing its first mayor, but
in any event he recommended the
appropriation.
It was a good thing, because the
Board of Managers had run out of
money and halted work for six months.
Accounts of the time say that the
managers had raised $21,000, including
two state appropriations of $14,000.
That would indicate that by then the
local contributions amounted to only
$7,000, perhaps because the hatting
industry was suffering a slowdown in
the late 1800s. The Board of Managers
met its first big fiscal challenge and the
new hospital, which opened on Jan. 30,
1890, came in at a cost of $21,545.98.
One of the earliest photos of the hospital.
Note the trees in the foreground
The End of the
Victorian Era
M
ost readers will recognize the
‘new’ hospital. The often-photographed
Queen Ann-style Victorian building
hewed closely to the typical ornate
design prescribed by the sensibilities of
the time. But the era of conformity and consolidation was drawing to a
close during the last decade of the century. America’s biggest migration
in history, the Oklahoma land rush, was on. The Spanish-American
A good shot of the Queen Ann style
hospital showing the wooden ward
wings that survived into the 1970s.
9
THE EVENING NEWS, TUESDAY, APRIL 10, 1894
TRAINING SCHOOL FOR NURSES
An Advance Step by the Hospital –Some of the Needs of the Institution.
The managers of the Danbury hospital
have perfected every arrangement to
give a two years course of training to
young women who want to become
professional nurses. This has been the
dream of the managers for the past four
years, and it does appear as if they had
succeeded better than they were aware
of, inasmuch as the best medical talent
in Danbury and vicinity, irrespectively
of school, have agreed to deliver lectures.
This satisfactory result has not been
accomplished without some hard
work and diplomacy on the part of the
directors, but it has been accomplished
and is satisfying to all concerned. The
advantages of the training will therefore
be apparent.
Applicants to the school must be
single women between the ages of twenty
and thirty-five. They must possess a
good education, be of perfect health
and must furnish testimonials as to
character. In short, that must possess
and furnish the same qualifications
as are required in all training schools
throughout the country. Nurses must
be under training two years. The first
month must be probationary. During
the month of trial and previous to their
obtaining a position in the school they
will be examined by the superintendent
of nurses in reading, simple arithmetic,
English diction and penmanship. This
amount of education is indispensable.
Of course, the better qualified the
applicant the better the chances – the
same being true in all other professions.
The superintendent of nurses has full
power to decide as to their fitness for the
work and the desirability of retaining or
10
dismissing them. The hospital rules in
this regard are practically the same as are
in vogue elsewhere. It may be stated right
here that there are seven nurses in the
hospital now, which is the full class.
The course of instruction is from
October to June each year. The school
of instruction was successfully launched
last week. This spring term will end
in June. The lecture days are Tuesdays
and Fridays. The training school is
under the control of a committee of the
hospital directors, consisting of Joseph
H. Schuldice, Mrs. Joseph T. Bates, Miss
Susie Crofut, and Mrs. Joseph M. Ives. A
committee of nine physicians appointed
each year by the Danbury Medical
Society, acting in conjunction with the
hospital board and the superintendent
of nurses, have charge of the lectures,
instruction and examinations. This
committee have the whole medical field
in the city and vicinity to choose from as
the ones best qualified to deliver a curtain
lecture on special subjects. The medical
committee for the present year are Drs.
Brown, Brownlee, Clark, Scott, Snow,
Stratton, Watson, Wile, of Danbury; and
Dr. May, of Bethel.
At the end of the two years’ course the
graduate will receive a diploma signed by
the training board and the committee of
examining physicians.
If the plans of the training school
committee are successful, and there is
no reason to doubt but that they will be,
the Danbury hospital will have one of
the best training schools in the state, and
nurses graduating from the institution
will have every reason to feel proud of
their diploma.
The Needs Of The Hospital
While on this subject, the attention
of the citizens of the town is called to
the needs of the hospital. The town has
outgrown the institution, and so rapidly
that the directors are at their wits end
for room. Just twice the room is needed
for the uses it is put to at present. At
least another wing should be added and
more private rooms are needed. Among
other needs are a larger operating room, a
laundry which should be separated from
the hospital building proper, and above
all a separate building for contagious
diseases. These problems are what the
hospital board have to contend with
now. The project for a separate building
for contagious diseases is one that will
commend itself to every one and ought
to receive instant and hearty support.
Besides the above wants many of
the rooms are in need of painting and
repairing.
There are some annoyances about the
hospital that should be abolished, and
that is in regard to visiting. Sometimes
the hospital people are run to death
with over-anxious friends of patients
at all hours at most inconvenient times.
The annoyance has led to the adoption
of a rule to the effect that relatives and
friends may visit patients between the
hours of two and five afternoons with
the exception of Sunday, and then only
by permission of nurses or one of the
managers. There will be exceptions
to this rule, of course, when necessity
requires it.
War came and went and the French gave America the Statue of Liberty.
The world saw its first movie, its first flight, and its first automobile. Dr.
Roentgen developed the first application for X-rays and won a Nobel Prize
for it. Felix Hoffman found a way to make aspirin easy to take. Medical
innovation brought much-needed vaccines for the plague, tetanus and
diphtheria.
There were other, better-known medical
treatments offered at the time; some blurred
the lines between pure medication and alcohol
or even codeine. This was the heyday of the
patent medicines that were promoted as cures
for anything and everything.
Electric lights came to Danbury and to
the new hospital, where money to operate
the institution was still tight. Doctors and
merchants played ball on Main Street to
raise money. The Danbury Fair continued
to provide dollars from several events. The
hospital by then had created a formal Hospital
Aid Association specifically chartered to raise
One patent medicine, Lydia Pinkham’s
funds and free up the Board of Managers so
Vegetable Compound, was a very
that it could focus on running the hospital.
A Women’s Auxiliary formed and provided
popular women’s tonic. It went on
support, including raising money and
to inspire what may have been the
securing needed goods.
first musical jingle, followed by a
Danbury Hospital launched a training
host of bawdy drinking songs. Lydia
school for nurses in 1893. The undertaking
deserves mention for several reasons.
and her “medicinal compound” are
Supporters were able to raise funds and it
memorialized in the folk songs “The
provided the hospital with nursing assistance
Ballad of Lydia Pinkham,” and “Lily
at a low cost. It also marked the hospital’s
the Pink.” It should not pass without
entry into the field of medical education. The
school’s demanding criteria made for selective
mention that the reason a humble
admission. The rigorous, well-planned
women’s tonic was the subject of such
program resulted in a highly trained nursing
ribald drinking ballads was its 40-proof
staff. And, as they would many times over
alcohol patent eye-opener.
the years, the hospital, the medical staff, and
the community worked in partnership to
perfect the program.
11
A New Century
A Tricky New Law and Some Very Modern Approaches
D
uring the early 1900s, hospital finances continued to be tenuous.
Whenever an excess could be generated it went into the building fund,
along with money raised by the Women’s Auxiliary and the Hospital
Aid Association. Danbury-area residents might think 1903 ranks as
an important year because Henry Dick closed his saloon and opened
his furniture store, but in the history of the hospital, 1903 stands as an
extraordinary year for other reasons. In the annual report for that year the
Hospital Board of Directors used the strongest language ever to describe
the need for a larger building. Figures showed that the average daily census
actually exceeded the 21 beds.
But the most significant part of the annual report involved an action by
the state Legislature, an action that marked the beginning of Connecticut’s
oversight of hospital operations that continues to this day. Each year
Danbury Hospital made an
appropriations request to the
state. In 1903 the legislature
changed the law regarding the
appropriation and laid down
very explicit conditions for the
money. Here is the wording of
the new law:
One of the earliest Classes at the nurses
training school. Mrs. Sue Cutler,
Center, is the Superintendent.
12
Section 1. The following sum
is hereby appropriated to be paid
out of any money in the treasury
not otherwise appropriated, in
full compensation for the object
hereinafter specified for the two
fiscal years ending September
30th 1905: For the Danbury
Hospital, ten thousand dollars: provided, however, that no part of this
appropriation shall be paid until the said Hospital has organized a competent
staff of physicians and surgeons and shall receive and treat State and Town
patients for a sum not exceeding five dollars per week.
The state used its financial clout to
force Danbury Hospital to organize a
medical staff and to accept state and
town patients for a set (and relatively
low) fee. In the annual report the
board said, “After much deliberation
it was deemed advisable to comply
with the requirements of the
Statute rather than lose the annual
appropriation from the State which
would seriously cripple the work of
the institution.”
The board went on to appoint its
first medical staff 4 and immediately
charged the members to prepare a
report on the needs for the new hospital.
In 1904, with cots now lining the halls of the hospital, the medical staff
made its deeply felt and lengthy report. It contained these highlights:
Surgery circa 1900, gloves and masks were
not yet standards of care. From left,
Dr. Stratton, Dr. Selleck, Dr. Brownlee.
The building should be of brick construction and fire proof.
Locate it in front of the existing hospital and connect it with corridors.
Create separation of surgical cases from medical cases.
Create an emergency room and a recovery room.
Completely upgrade the operating room and sterilization facilities.
Establish space for both obstetric and pediatric care.
Create more private rooms in the new building and convert the older
building to nurses’ quarters.
Install a new elevator and an incinerator.
One of the most graphic requests involved creating one or two retention
rooms for contagious patients. The doctors described a contagious patient
who had to “sit out under the trees until he could be removed.” 5
The Board accepted the report and formed a Building Committee.
During the next few years, as the Building Committee went about its work,
fundraising went into high gear. A Friday Club of Young Ladies formed to
raise money and supplies. The Women’s Auxiliary grew to 35 members,
all working to support the new building. The first full-dress Hospital Ball
was held at the armory and raised $267 for a sterilizer. The Hospital Aid
Committee prepared a money-raising campaign with innovations and a
level of detail that today’s Development Fund would admire. Through
4 The staff included Drs. Clark, Brownlee, Brown, Sellek, Stratton, and Watson representing the Danbury Medical Society, and Dr. Sundland representing the Homeopathic Medical Society. Dr. W. C. Wile was appointed as consulting physician and surgeon, essentially Chief of Staff.
5 Those who want to read the doctors’ own words spelling out not only what they recommended, but why, can find the document in the 1904 annual report in the Horblit library archives.
13
the committee’s aggressive lobbying, the state Legislature was convinced
to approve $35,000 for the new building. Even though the hospital raised
its rates from $6 to $7 for wards and from $10 to $12 for private patients,
revenue didn’t cover operating costs. One financial statement showed
patient revenue of only $6,224, with expenses of $16,263. The expenses
included $5,685 for meat and groceries and $4,770 for “help.’’
Free Beds – To meet the challenge of raising money, the hospital
developed an innovation in endowments and naming opportunities.
The hospital was not the only major
addition to the community being
advanced in the early 1900s. The Normal
School, now Western Connecticut State
University, opened in 1905.
14
Free beds may be established in the Danbury Hospital under the following
conditions, which have been approved by the Board of Trustees:
Any person or persons contributing at any one time for the use of the
Danbury Hospital the sum of five thousand dollars, shall be entitled to establish
a free bed in any of the wards of the Hospital and if requested such bed shall
be named as desired by such contributor. And such contributor or their legal
representative shall be entitled to nominate and keep from time to time, subject
to the rules of said Hospital, one person as a patient in the Hospital who shall
have the benefit thereof, free of expense, for a period not to exceed six months in
any one year, the time to be governed by the cost of care and the income derived
from the endowment.
A Far-Reaching Reorganization
D
uring this time the hospital undertook a landmark reorganization,
one that laid the foundation of the structure we have today. The structure
labels have changed over the years, but the roles have remained almost as
they were described in 1908.
The role that individuals in the community had played as members of
the society and other committees was recast under the title incorporators,
though many paid for the privilege of still being listed as honorary
members. Next, a 30-member Board of Trustees was formed. Trustees
included citizens from area
towns and the Danbury
mayor and selectman. The
trustees were to provide
oversight and consultation
to a new 12-member
Board of Managers, which
was charged with the
responsibility of running the
hospital. From this point
on, the Board of Managers
prepared the annual report.
The first annual report
from the new board
contained a fascinating
passage. For the first time,
but far from the last, the
hospital asked for community
understanding regarding charity care.
“Special attention is called to the statistical report of the Hospital work in
which is shown, by analysis, the charity work of the hospital for the past year.
This work is so little understood by the public, this concise showing cannot fail
to be appreciated.”
Anesthesia in Danbury Hospital
circa 1908.
The managers go on to show the financial impact of free care and make
a strong case for more appropriations from the towns and more donations
from the public.
15
The just-completed 60-bed hospital
6 The consultant is referred to as “Mr. Sturns, a celebrated expert on hospital buildings.”
16
The Building Committee appointed a publicity subcommittee to
present the plans to the people of Danbury using the public press. They
worked hard to get lithographs into the newspaper so that people could
comment on the plans, but they got little response. However, the publicity
committee did get people to turn out for a meeting in July and the building
program was approved.
Direct mail fundraising, corporate reorganization, public relations, and
discussions of charity care were not the only modern-looking actions going
on. The Building Committee discovered how to use consultants. The
committee held competitive bids, which came in at between $126,000 to
$176,000 and were deemed to be too high, prompting members to hire
an outside expert all the way from Chicago. 6 The consultant was able to
offer advice that, when worked into the re-bid, brought the price down
to $80,000, and a contract for that amount was let to the Wales Lines
Company of Meriden. Ground was broken for the 60-bed brick addition
on Nov. 5, 1908.
Energized by the construction activity, money rolled in. With another
$15,000, the state brought its appropriation total up to $50,000. Local
donations topped $40,000, including enough from the citizens of
Brookfield to furnish the Brookfield room.
The free bed endowment grew to $20,000. An innovative area-wide
fundraising campaign called “Tag Day” raised close to $4,000. The
scheme involved giving everyone who made a donation to the hospital fund a tag to be worn for all to see. The stigma of being without a tag
proved to be a strong incentive to donate. Dr. D. C. Wile, chief of the
medical staff, donated his medical books and the furnishings for the
creation of the Wile Library.
All of this was good news for the board because it had taken a big
gamble. Members signed the contract for $80,000 -- but their own
estimates were that the cost would be closer to $90,000, and that didn’t
include furnishings. And they signed just as the admissions to the hospital
took a drop! In spite of everything, including having to unexpectedly blast
rock, the gamble paid off.
On May 1, 1910, 25 years after the first hospital opened, the new
three-story, 60-bed brick building admitted its first patient. The drop in
admissions proved to be temporary and the new building quickly filled.
The managers ran the hospital in both buildings for a while, but then
converted the wooden Victorian building to nurses’ quarters.
The brick building begun in 1908 and completed in 1910 still exists and still serves patients. It is now known as the Center Building.
The Hospital
Endowment Fund
The accumulating
funds grew so large
that the hospital felt
a need to create a
special organization.
The presidents of four
banks, Danbury National,
City National, Savings
Bank of Danbury, and
Union Savings Bank
became the trustees of
the Danbury Hospital
Endowment Fund,
charged to manage the
investments of money
willed, donated or gained
through other programs.
1896 - 1910 Hospital Statistics
500
ADMISSIONS
BIRTHS
400
300
200
100
1896
1910
17
Chapter 2
The Young Twentieth Century
Revolutions, Wars and Epidemics
1910-1920
Famous 1917 Poster.
National Archives
18
D
ramatic events gripped the country and the rest of the world in the first decade after the new hospital opened.
But while war, disasters, epidemics and local problems raged, the
hospital made continual, if incremental, progress.
Revolution and war erupted around the world. In China, the Manchu
Dynasty was overthrown and Sun Yat-Sen proclaimed the birth of the
Chinese Republic. An attempt at democracy in Mexico resulted in a flawed
election followed by a revolution. The Mexican revolution spilled over to
the southwestern U.S., creating the motive for General Pershing’s failed raid
into Mexico in search of Pancho Villa.
In 1915 a German submarine sank the British passenger liner Lusitania, killing nearly 1,200 people,
many of them Americans. That event, plus a sabotage explosion of a munitions dock in New York
harbor, swung American opinion and early in 1917 the U.S. entered the war. “Uncle Sam Wants You”
placards appeared on buildings all over Danbury. The war continued until November 1918.
During the war the Russian revolution also claimed a share of the world’s headlines. The revolution
bled into a civil war and set the stage for the establishment of a socialist state. By the end of the decade
the Soviets would control worldwide communism.
War and revolution were not the decade’s only tragedies. The Triangle shirtwaist factory fire in New
York killed 146 people. The Titanic sank after hitting an iceberg, with more than 1,500 lost.
The period between 1910 and 1920 wasn’t all disaster. After 35 tumultuous years the Panama Canal
officially opened. Henry Ford developed the first moving assembly line and by 1914 had produced a
million Ford cars. Daylight saving time began during World War I, primarily to save fuel by reducing
the need to use artificial lighting.
THE YOUNG TWENTIETH CENTURY REVOLUTIONS, WARS AND EPIDEMICS, 1910-1920
19
The first nursing class to graduate
from the new hospital in 1910.
Horblit Health Sciences Library.
20
People in Danbury were spending time being confounded by a new
amusement called the crossword puzzle. Some attended games in the
Yale Bowl, the nation’s first football stadium. They went to see Charlie
Chaplain as “The Little Tramp,” were introduced to Tarzan of the Apes,
and read Agatha Christie’s first mystery.
Entrepreneurship was flourishing and along with it came charlatans with
inventive schemes. To help curb these excesses, the Associated Advertising
Clubs of America founded the National Advertising Vigilance Association
to promote “truth in advertising” principles.
Doctors in the community were pleased when the American Medical
Association published its first volume of “Nostrums and Quackery,” a
compilation of medical and health frauds of the day. Medical frauds were
so pervasive that the AMA would require nine extensive annual editions of
unique articles to expose just the most well-known medical misadventures.
The field of medicine created two other important associations. The
American Society for the Control of Cancer, later renamed the American
Cancer Society, and the Association for the Prevention and Relief of Heart
Disease, now the American Heart Association, both came into existence in
these early years of the 20th century.
Though fraud existed, medicine
did make real advances. Marie
Curie’s work with radium earned
her the Nobel Prize. Paul Erhlich
devised the treatment for syphilis,
regarded as the birth of modern
chemotherapy. “Vitamins” were
first recognized as substances that
prevent deficiency diseases such as
scurvy and they became a method
of treatment.
At the Hospital
At Danbury Hospital Sophia
Penfield, M.D., became the first
woman on the medical staff. She joined as the homeopathic member in
1913. That same year Margaret Rogers resigned as Superintendent and was
succeeded by Mary Durnin, who would hold the post until her death in
1921. The annual reports for those years reflected that costs were higher
than income. The board pointed out to the community that the fixed
amount towns were paying to treat their charity patients did not cover the
cost of their care. To make its point, the board began adding a special
section to each annual report detailing the hospital’s expenditures for
treating “town” patients.1
The nurse’s training school made its 20th report with 20 in its class.
Diploma schools of nursing, such as the one at Danbury Hospital, were
and would remain for years the major source of nurses.
The build-up for World War I brought a rapid shot in the arm for the
local economy because the Army needed hats — thousands and thousands
of hats.
The hospital wisely chose this time to launch a very highly publicized
drive and was able to report that it paid off all debt.
Admissions grew steadily, requiring the hospital to convert two solariums into two four-bed private wards. A part-time pathologist was
added to staff. As the decade moved on, the free-bed endowment grew
to seven and Mrs. LaSalle donated an ambulance. The training school
expanded from two-and-a-half to three years and made a major revision to its program.
The hospital saw admissions more than double to 1,500 and births reach 200 during the period and so kept up its program of space revision.
Miss Mary Durnin, R.N., Superintendant
from 1913 to 1921, in the office set aside
for the superintendant when the 1910
building was completed. Note the
telephone at the right, far from
Miss Durnin’s desk.
As part of a massive fundraising
campaign, articles like this one ran
for days in the newspapers.
1 The calculation of costs to the hospital for providing charity care could be considered a forerunner of today’s “Community Benefit” report.
21
1915 patient care.
22
The standard of care for community health was shifting away from home
births and the hospital’s
maternity case load reflected
that change. Responding
to the challenge, the Board
of Managers started to use
the annual reports to build
a drum beat for a dedicated
maternity unit. The managers
also directed the installation
of a new boiler and a true
isolation ward.
In 1917 the first of two
The hospital publicized its substantial regional nature
devastating epidemics arrived in its 1917 annual report.
in Danbury. Polio had hit
New York and Boston in the previous year with tens of thousands affected.
Once here, the disease and the deaths it caused would continue to break
out every summer for decades to come.
The Spanish Flu arrived in 1918. The influenza pandemic would
eventually kill 20 million people worldwide, 600,000 of them in the
United States, far more than the number of American soldiers killed in
World War I. Residents were told to stay home and avoid crowds.
Schools and theaters were closed and many meetings canceled, as the flu
was known to be spread through close contact. A person wearing a white
cotton mask was a commonplace sight on the streets of Danbury. The
hospital reported 50 cases of Spanish Influenza and 42 cases of pneumonia
associated with the flu. The toll of the epidemic in Danbury is difficult to
tally. Death certificates might list influenza, pneumonia, or “the grippe”
as a cause of death.
Theater-going was discouraged during
the 1918 influenza epidemic.
National Archives.
Cotton masks actually provided little
protection from the flu.
23
A photo of hospital leaders of the early
20th century. Names were not provided.
A Community Saga
D
ietrich E. Loewe had been a driving force behind the creation and
early success of Danbury Hospital. He was a prominent hat manufacturer
and became president of the hospital when that position was formalized in
1901. Possibly under the stress of his court battles with the hatters’ union,
Loewe resigned as president in 1913 and was succeeded by Charles A.
Mallory, another hat manufacturer.
As the decade drew to a close and World War I ended, the local economy
hit one of its down cycles when the demand for military hats dropped off.
However, the hospital ended 1919 on a high note. The managers had
ordered that the first-ever physical inventory be taken. When they finished
their count of drugs, laundry, and all types of supplies, they were pleasantly
startled to find they actually had $2,000 more of these supplies on hand
than the books had shown. The board included in that report its most
specific requirements yet for a new building dedicated to maternity and
surgery, to be located to the east of the present 60-bed brick building.
24 THE HISTORY OF DANBURY HOSPITAL
Dietrich Loewe
Danbury Hatter and Hospital President
Surprisingly, the hospital annual reports between 1910 and 1919
make no mention of the single most important story in Danbury at the
time. The “Hat City” of Danbury had made news back in 1902 when
hat manufacturer Dietrich Loewe refused to recognize the hatters’
union. Most of his employees went on strike. Loewe resumed work
with a scab crew, and the striking workers organized a boycott that
was carried to other states wherever Loewe’s hats were sold.
Loewe filed a lawsuit and the U.S. Supreme Court in 1908 ruled
against the strikers. In 1915 the court again decided in favor of Loewe,
allowing him to collect damages from individual workers. Faced with
the possibility of losing their homes, the hatters union organized a
“Hatters’ Day,” asking for an hour’s pay from members to help pay the
fines. The union stepped in and took care of the balance.
Dietrich Loewe was president of Danbury Hospital during that time. His
attorney, Walter Merritt, was a board member. One might think that their notoriety would have turned the people of Danbury against the hospital, but that
wasn’t the case. An article in the Jan. 10, 1915, New York Times summed it up:
“In the twelve years that the Loewe firm has been fighting an interest with
which all the rest of Danbury, willing or unwilling, is tied up, the family never met
with any indications of hard feelings in the town. None of the unionized manufacturers have displayed coldness toward the one irreconcilable or toward his
family. And, from 1901 to 1913 Mr. Loewe was President of the Danbury Hospital, a position he could hardly have held if his fellow citizens had disapproved
violently of his course. The affair does not seem to have ruffled him at all but
maybe he is more interested in it than he appears; for it was that quiet voice that
made the officers of United Hatters think that they could get him.”
He resigned as president of the hospital in 1913. The strike and the demise
of the hatting industry left him broke and in 1928 his friends set up a charitable
annuity that was quickly oversubscribed. Dietrich Loewe died in 1935.
Dietrich Loewe was a hospital leader
and national figure.
Danbury Museum and Historical Society
1910-1920 Hospital Statistics
1600
ADMISSIONS
BIRTHS
1400
1200
1000
800
600
400
200
1920
1910
25
26
Hatters in the pressing room.
27
Chapter 3
From the Roaring Twenties
Through the Great Depression
1920-1940
28
The Roaring Twenties
T
he war ended, prohibition became law and the 19th
Amendment gave women the right to vote. The postWorld War I United States embarked on a decade of seemingly
endless economic growth laced with giddy speculation. America
became electrified, changing life for millions.
Danbury Hospital kept pace with these changes and continued to see
rapid growth. Though the hospital had only 60 beds, it once recorded a
daily census of 81 with patients lining the halls. Plans for the new wing
and for new quarters for the nurses went into full swing. In May of 1920
the hospital launched an ambitious new campaign to raise $250,000. In
November the pledges totaled $260,000 and the managers were brimming
with confidence and full of appreciation.
But by the time the construction contract for the East Building was let in July of 1921 the managers
had replaced their confidence and appreciation with grim reality. The pledges did not come in. Perhaps
Danburians felt other pressures — children were going to school in store fronts and butcher shops for
lack of class rooms — but for whatever reasons, only $156,000 of the $260,000 pledged was actually
contributed. The original contract of $172,000 for the East Building required all available funds and left
the hospital $70,000 short for the nurses’ quarters. The annual report describes the difficulty of their
decision, but the managers felt they had to put the limited funds toward the new treatment building,
postponing any relief for the nurses’ living situation. The decision surely caused a problem for Anna
Griffin, who became hospital superintendent that year when Mary Durnin died after a short illness.
FROM THE ROARING TWENTIES THROUGH THE GREAT DEPRESSION, 1920-1940
29
The 40-bed East Building opened in 1922.
Nursing food nutrition class.
30
The hospital reported remarkable progress in just a year. The east wing
went through design changes and cost increases but was opened in the fall
of 1922, adding 40 beds. The entire second floor was carefully designed
especially for maternity cases. Demand was so high that the managers
canceled an open house and dedication in order to get patients admitted
and under treatment. Their action may have been influenced by the added
revenue to be gained, as the new wing was a financial success and the
hospital enjoyed a boost in patient revenue.
Several annual reports made impassioned pleas for all pledges to be
paid in order to provide housing and better living
conditions for the increase in nurses required to staff
the new addition. The hospital faced a nurses' shortage
and needed the better conditions to attract more staff.
The 1922 annual report contained the description of a
challenge that has faced the hospital for many periods in
its existence right up until the present time.
There are now enrolled in our training school twenty-nine
(29) earnest, ambitious, young women who are receiving a
thorough course of training and education in their chosen
calling under competent instructors. The demand for trained nurses is very
great throughout the world, and Danbury Hospital with its increased capacity
and facilities offers exceptional opportunities to our young women for a very
thorough course of training in their chosen vocation, and in this connection your
attention is called to the annual report of the training school, which will be
submitted to you and printed in the Year Book.
A second community-led fund drive proved successful and the new
nurses’ quarters did get built and opened in 1929. Today it is the North
Building.
The hospital managers and staff labored all through the 1920s to keep
up with demand. Admissions between 1919 and 1929 more than doubled
from 1,200 to 2,500. Just as it does today, growth meant challenges. The
new wing brought more than just a need for additional nurses. Managers
recognized that the larger hospital required more skill and coordination to
run, and more new technology, such as up-to-date X-ray equipment.
At the same time, improvements in medicine meant more and more
ways to care for patients. Among the most profound advancements was
the continued development of vaccines. Vaccines for diphtheria, pertussis,
tetanus, and yellow fever all entered general use.
During this hectic time the hospital achieved an important quality
milestone not unlike those of modern times. After reporting on a new
ambulance, a new one-day surgery room and a new laboratory, the annual
report of 1924 proudly contained this announcement:
The hospital built both the East and
North buildings in a short span of time in
the 1920s. The East building addressed
the need for patient beds and the North
building, shown at left, provided muchneeded quarters for its nurses.
31
The photo shows the filling of Candlewood
Lake during the summer of 1928. The
photo is taken at Leach Hollow in
Sherman.
The Sherman Historical Society.
1919-1929 Birth Statistics
BIRTHS
340
300
260
220
180
1919
1929
1919-1929 Admission Statistics
ADMISSIONS
2400
2200
2000
1800
1600
1400
1200
1919
1929
The board asked the community to note
that “there is a continued increase in the
use of our hospital's facilities, indicating
that the hospital is fulfilling its mission
and has the confidence of the community
it serves.”
32
The outstanding accomplishment of the year 1924 has been the successful
culmination of the efforts of the entire hospital staff to meet all the exacting
requirements of the American College of Surgeons and earn the rating of
"An Approved Hospital." The granting of this certificate places the Danbury
Hospital in rank with the best hospitals in the country, and is a source of
pride to this community and to the hospital staff, who have worked for its
accomplishment.
Like much of the country, the Danbury area got through the decade very
well. Dr. Fabian of Brookfield found a substitute for mercury that ended
the so-called hatters’ disease. The formation of Candlewood Lake brought
a real estate boom and, in spite of the 1929 crash, the hatting industry
sprang back to life thanks to a fictional European noblewoman. In the
movie “Romance,” actress Greta Garbo wore a soft hat pulled over one
eye. The Empress Eugenie hat was an instant fashion success and hat shops
rushed into production.
The Danbury Hospital board made the community very aware that
the hospital, too, had done well during the 1920s. A substantial section
of every hospital annual report from the period recognizes and thanks
the community, the staff, the auxiliary and the donors, many by name.
The paragraphs devoted to praising its constituents were often expansive
and always sincere. The hospital never appeared to separate itself from its
community.
The Depression Years
T
he 1930s dawned gray. Depression gripped the U.S. and much of the
world. The German economy had already collapsed, providing Adolph
Hitler a ready situation to promote his Nazi programs. Japan invaded
China and soon Mussolini would attack Ethiopia.
The Spanish Civil War attracted the world’s attention
and became the focus of artists, novelists, and
photographers.
In science, the atom was split and Einstein wrote
President Roosevelt suggesting the potential for a
nuclear chain reaction. Chromosomes were linked
to heredity and ways were found to store blood in
the country’s first blood bank. The Empire State
Building and Boulder Dam were both completed
in this decade, as were hundreds of Civilian
Conservation Corps (CCC) and Works Projects
Administration (WPA) projects. The CCC and WPA
operated to employ workers idled by the Depression.
Working against these efforts was the long drought
and prevailing winds that caused the Southwest to
become known as the Dust Bowl.
Prohibition was repealed, though too late for Al
Capone, who was already serving time in prison.
Bonnie and Clyde were shot, more or less ending the
Roaring Twenties.
People in Danbury were absorbed by the kidnapping
of the Lindbergh baby, the birth of the Dionne
quintuplets, and the movie “Gone with the Wind.”
In 1933 Connecticut would smile with pride on the
only Miss Connecticut to ever become Miss America, Marion Bergeron.
The Danbury Hospital annual report for 1930 contained two important
messages. The first related to the hospital's endowment, which never was
as strong as those of other hospitals and was always a source of concern for
the board. The endowment received a big boost from Mary Hawley, who
donated $100,000 plus an additional $25,000 for free beds for Newtown
residents.
A young girl identified as Emma Barch
standing in front of the hospital about
1930.
33
The other matter of significance might sound oddly familiar and
current. It involves the hospital’s early relationship with Yale’s School
of Medicine.
A much-needed forward step has been taken in the employment of a
full time pathologist. Heretofore we have endeavored to carry on this
branch of our work on a part-time arrangement with one of the staff
and this is not working out satisfactorily. Arrangements were made with
the Yale School of Medicine to have our specimens examined there. We
received the fullest measure of cooperation from them but considerable
delay was necessarily occasioned in sending and returning the specimens
to and from New Haven and the only solution of the problem seemed to
be our employment of a resident full time pathologist. For this work we
have been fortunate in securing the services of Dr. Edward I. Bowlus of
Baltimore, who has a record of accomplishment and experience which
assures us of highly efficient work in
this department.
Mary Hawley of Newtown donated
$125,000 to Danbury Hospital just
as the Depression began.
Cyrenius H. Booth Library.
1 During this time the annual reports gave increasing attention to hospital operations and the superintendent's report grew in size and importance. In some years,
figures given in the superintendent's report, the presi-
dent's report, and the treasurer's report were at variance, but were always reconciled in the following year's report.
34
During the early 1930s, hospital
annual reports made it plain that
the Depression had affected people’s
ability to donate and to pay their bills.
Individual donations were sought for
microscopes, a respirator, and other
equipment.
A special President’s Ball raised
money for an Infantile Paralysis fund.
Managers minded their budgets, kept
Not many area residents noted in 1931
expenditures modest and the hospital
avoided any financial crisis. Admissions that a young John F. Kennedy had
been admitted to Danbury Hospital
held steady and much credit for the
for appendicitis.
hospital’s sound position was given to
Anna Griffin, the superintendent who, in 1934, gained membership to the
American College of Hospital Administrators1.
In 1935, 50 years after the hospital opened, two of the most important
people in the hospital’s history passed away: Dietrich Loewe, who led the
hospital from the turn of the century to 1913, and Charles A. Mallory, who
in 34 years had served as trustee, vice president and president. The two
had combined to provide nearly a half-century of stewardship during the
hospital’s formative and potentially risky years. Arthur Tweedy in his first
annual report paid tribute to his two predecessors and then began the push
for the next expansion. He focused first on the need for more beds. He
reported that contagious patients
now presented a special and
worrisome problem to the hospital
and the medical staff. Danbury
Hospital could not accommodate
the cases and had to make
arrangements with the Englewood
Isolation Hospital in Bridgeport to
take the overflow. No one liked
seeing local people being sent away
for care.
Tweedy then turned to the
need for a new power plant. The
present power plant located in the
basement of the original building
was by then a much-repaired relic
taxed to its limit. Tweedy’s reports
in 1935 and 1936 are sobering, and
by the end of 1936 he had a special
committee from the Board of
Managers working on plans to raise
funds for extra bed capacity and a
modern power plant.
The committee quickly pulled
together a building fund campaign
and raised more than $300,000.
The amount missed the goal, but
provided enough to get a building
committee formed and set to work.
Mr. Tweedy carefully guarded the
hospital’s excellent credit record
and promised “not to award any
contracts unless the money with
which to finance them is assured.” He gave special recognition to the
people of Ridgefield for their contribution to the new building.
Mr. Sperry, chairman of the Building Committee, responded in 1937
with a creative proposal that met all needs by setting the new building at
a 45-degree angle from the main building and placing the power plant by
A shot showing the angled
West Building.
A photo of the business office in 1937
with a still-recognizable name on the
calendar.
35
The West Building opened in 1939,
adding 60 patient care beds.
A patient care room in the new
West Building.
36
itself at the end of the building
— joined, but essentially standing
alone.2
The angle minimized the
disturbance to the older building
and, by using load-bearing walls, the new building could be expanded upward.
During the last two years
of the decade, as construction
went forward, the hospital took
increasing notice of its financial
operations. Admissions jumped
from 2,500 in 1930 to 3,300
in 1939, a 32 percent increase.
During that time revenue from
patients seldom fully covered the hospital’s operating costs. The town
payments, the interest from investments, and borrowings were often
needed to bridge the gap.
In the 1938 annual report the board made one of its strongest cases for
more money from the community. The hospital treated charity patients
sent from both the town and the state under a fixed fee per patient and
sent both bills to the town. The hospital learned that the town was billing
the state for its share of patients but was not passing the money back to
the hospital.
The 1938 annual report contained the first, but mysterious, mention
of a subject that would forever be central to the hospital and the
communities it served: health insurance. The hospital faced a growing
challenge during these tough times as the amount of uncollectible debt
from patients climbed to tens of thousands of dollars. With what now
looks like extraordinary vision, the board reported action to address that
challenge, assist patients, and change the hospital’s financial situation.
"We have kept closely in touch with the rapidly developing plans to provide
hospital care within the means of those not financially able to pay the
prevailing rates. The plans are variously known as Group Hospitalization,
Hospitalization insurance, and are generally designed as the 3-cents-a-day
plans. Careful study indicated to your Board that these plans had great
merit and would benefit many of our people by providing hospital care at a
cost within their means. We, therefore, cooperated with a group of interested
citizens in the formation of The Danbury Hospital Service Company, a nonprofit organization, designed to carry out this purpose, and a contract has
been signed with this Company providing for hospital care at substantially
reduced rates to subscribers to the Service. The plan has worked out very
successfully, both for the subscribers, who receive hospital care in return for a
very moderate yearly subscription to the Service, and for the Hospital, which
receives prompt payment for services rendered."
The mystery arises because no record exists of the Danbury Hospital
Service Company and no mention is ever made of it again.
The new power house and West building opened in 1939. The hospital
now provided approximately 150 beds while the North building housed
the nurses’ quarters. The project took three years, which the board
pointed out was longer than anticipated, but then said “We have added
from 50 to 60 beds which will take care of the needs of the community
for many years to come.”
Confirming this board’s vision, it would be 20 years before another
major addition.
BIRTHS
520
480
440
400
360
1940
1930
3400
ADMISSIONS
3200
3000
2800
2600
1940
1930
2 The hospital configuration showing the angled West Building and the power plant smoke stack appears on the cover of hospital annual reports for most of the1940s.
37
Chapter 4
Through the War Years
1940-1950
38
I
n 1940 the people of Danbury, like most Americans, went about their days in quiet, growing apprehension. Germany had
invaded Poland and another world war was on the way. Anticipating
war, Congress passed the Selective Training and Service Act of 1940
and created a new vocabulary with words such as ‘caught in the
draft’, ‘A-1’, and ‘4-F’. The attack on Pearl Harbor in December 1941
began four years of a truly worldwide war.
Unfortunately, the dispositive use of atomic weaponry and the surrenders
by Germany and Japan provided only a transformation of international
tension. The United Nations was founded with great optimism in 1945
but less than a year later Winston Churchill, in his famous “Iron Curtain”
speech, provided the words that would be used for the next half century
when discussing the new tensions. By 1949 China proclaimed itself
socialist and the USSR had expanded into Eastern Europe, including
East Germany, and the Cold War began.
Though the first half of the decade brought war, the second half brought explosive growth in
the economy and the population. The economy of Danbury, typified by the Barden Corporation,
benefited from the emerging Cold War effort with orders for defense materials. By the late
1940s more people were employed in non-hatting jobs for the first time in more than 100 years.
McCrory’s window display on Main Street evoked Danbury’s pride in its service people.
THROUGH THE WAR YEARS, 1940-1950
39
A posed shot of plane spotters on the roof
of the Mallory factory on Rose Street.
Danbury, like much of the country, benefited
from government programs of all kinds.
The town bought the airport. The federal
government built the Danbury Federal
Correctional Institution. The G.I. Bill gave
veterans a ticket to the middle class with
money for college and for home loans. And
while Washington tapped Danburians with
the income tax and instituted withholding,
some people in town began receiving checks
for $22.54 each month as the first payouts
from Social Security.
Every decade can spark nostalgia but perhaps none more than the 1940s,
with the spirit of bonding sacrifice brought on by the war. The post-war
years brought a surge of development to the area, including a real estate
boom around Candlewood Lake.
The 1940s in Medicine
W
Ration books became an everyday part
of life during World War II.
40
orld War II, as all wars do, forced advances in medical practices
as war-zone physicians battled bleeding, infection and pain. Surgical
procedures advanced with experience and the use of pins or stabilizing rods
to help reduce pain. Bleeding and infection now could be fought with the
advent of safer transfusions that were based on blood type and the wonder
of penicillin. Discovered in 1929, it took World War II to bring penicillin
into wide-spread use.
Other advances in medicine included the introduction of more antibiotics
and development of vaccines for important diseases such as mumps and
influenza. The recognition of the importance of pap smears to detect
cervical cancer and the effects of rubella during pregnancy improved
women’s health care. Medical studies presented the first citations linking
cigarette smoking to lung cancer. Artificial hip replacement, pioneered
earlier, became a recognized procedure. Grand Rapids, Mich., became the
first city to add fluoride to its drinking water. A major advance brought
together casings for sausage making and the long-known anti-clotting drug
heparin to allow scientists to develop the first kidney dialysis machine.
Spurred by the invention, work and research on the kidney led to the first
kidney transplant in 1950.
This 1947 ad for
Arrowhead Point
in Brookfield was one
of many promotions for
lake-front developments
in the area.
Brookfield Historic Society.
41
Danbury Hospital
I
These proud photos of the interior of the
new West Building are the first photos
to appear in any Danbury Hospital
annual report.
42
n a false epiphany, the president of the
hospital opened his 1940 annual report
proudly describing a recent meeting in
which the members of the medical staff
“unanimously voiced their approval of the
Board’s work and pledged their loyal support.”
The decade would end with a much different
relationship.
The war brought many changes to the
hospital. Doctors, nurses, and other staff
who left for the service had to be replaced
somehow. The annual reports once again
laud the women of the community who
served as Red Cross Nurses, Nurses’
Aides, Gray Ladies, Yellow Birds, and in
the hospital’s own Auxiliary, all of whom
stepped up to fill the needs of the hospital
and its patients. Danbury Hospital’s training
school was selected as a United States Cadet
Nursing School and enjoyed a government
appropriation of $29,000.
The war effort required the hospital to
develop a formal emergency system, including
the large purchase of supplies and specialized equipment. The hospital
prepared for air raids with frequent drills and devised procedures for caring
for patients during blackouts. Management avoided a costly conversion
of the hospital’s boilers from oil to coal by successfully fighting for an
exemption.
The Depression and then the impact of the war shortages altered the way
the hospital received its individual donations. People were short on funds
and unable to respond to the all the pleas from the hospital and the many
other organizations seeking donations. In Danbury and other towns the
multitude of small fund-raising activities was replaced by a new method of
giving called the Community Chest. The hospital soon recognized that its
share of the Community Chest money was so little that it would need to
continue raising funds on its own.
In his reports as president of the Board of Managers during the war
years, Thomas Bowen paints a picture of a hospital short on staff, but with
high, sometimes overflow occupancy and strong financial performance.
During those years an anonymous donor pledged $50,000 if the board
could match it. Led by soon-to-be president Bernard J. Dolan, the board
raised far more, enough to pay all indebtedness.
The hospital made a subtle but important organizational change in 1944.
Anna M. Griffin, R.N., who held the title of superintendent since 1921,
was given the new title of “administrator.” Her first report as administrator
covered operational matters such as staff shortages and changes, patient
statistics and hospital expenses. She also reported that the hospital had
been designated as a penicillin depot hospital for Danbury and the
surrounding area.
The nurses training school graduation
class of 1942.
43
“The best kept secret”
A
lthough Danbury Hospital was and still is the most recognized
institution in the area, the hospital’s programs often are not well known.
That was the case when Danbury
Hospital started its first clinics and its
first cancer tumor board. Here is the
quote from the Annual Report of 1947.
FIRSTS - True
multidisciplinary
clinics for children
and cancer patients
This aerial photo from 1946 shows the
hospital’s new angled West Building.
Note the wooden buildings in the upper
left. These are the wings from the original
Victorian era hospital.
“It is not too well known that the
Danbury Hospital has taken an active
part, in cooperation with the State Board
of Health and the Connecticut Cancer
Society, in establishing clinics at the Hospital for the treatment of crippled
children and a clinic for the care and treatment of cases of a tumor nature.
Clinics for crippled children are held at the physical therapy department of
the Hospital on the fourth Thursday of each month, with the entire State staff
in attendance, consisting of two pediatricians, one orthopedist, three nurses,
one nutritionist, one social worker, a physical therapist and a special therapist
assisted by volunteer nurses’ aides from the Hospital. Transportation is
furnished by the Red Cross. From forty to sixty patients are treated each month.
“The tumor clinic meets at the Hospital on the first and third Fridays in each
month and one hundred sixty-four patients have received examination and
treatment during the past year. Dr. John D. Vita of the Memorial Hospital,
New York City, is tumor clinic consultant and there has been an average of
ten local doctors present at each clinic meeting. The need for these clinics is
evidenced by these facts, and it is a source of gratification to know that the
Danbury Hospital has actively cooperated in these efforts and placed the
facilities of the Hospital at the disposal of those taking part in the fight against
malignancy and allied diseases, and in the effort being made to aid crippled
children, our own Pathologist and Radiologist being in attendance.”
44
Postwar boom
Infant care enjoyed technical advancement
during the baby boom years.
T
wo of the hospital’s post-war statistics shot up; one had an obvious
cause but one is a mystery. Maternity participated fully in the baby
boom. Births had been between 650 and 750 per year during the war
and then jumped up, much as they did all over America. While the postwar baby boom explains that growth, a mystery surrounds emergency
room visits. Those, too, had been averaging 600 to 700 visits a year but
then shot up to nearly 2,000. We can’t make a case that the two are
connected because only a few maternity cases would have come through
the emergency room. Second, the births soon dropped back and leveled
off while emergency room visits continued to rise.
Neither the board president nor the administrator make mention of
the increase in their reports. No statistic — population, industrialization,
the closing of another hospital — seems to explain this huge increase in
emergency activity. It’s possible that the hospital or some agency made a
change in classifying emergency room visits, but none is mentioned.
In 1948 Bernard J. Dolan became the president of the board. His 1948
and 1949 annual reports are among the shortest in history. He stressed
finance, citing a safety campaign that would cut down the hospital’s
insurance rate. He formed an Efficiency Committee of the Staff that
would begin by meeting monthly with the executive committee of the
board, but he planned more meetings, “gradually bringing in the heads of
all the different departments.”
Life is about to change for Danbury Hospital and the people it serves.
1940-1950
Birth & Emergency Visit Statistics
BIRTHS
1800
EMERGENCY VISITS
1600
1400
1200
1000
800
600
1950
1940
45
Chapter 5
From Dark Clouds to Blue Skies
1950-1960
46
The Skies Darken
A
“
ny consideration of the present situation of the Danbury Hospital may properly begin with the acknowledgment
that many mistakes have been made by many people. Having said
this, the quicker the conflicts precipitated by these mistakes are
relegated to the past and forgotten, the sooner will the rehabilitation
of the Danbury Hospital be accomplished.”
Those blunt opening words of a report by Dr. Nathaniel W. Faxon capture
clearly the situation at Danbury Hospital in early 1953. Dr. Faxon, a wellrespected physician and director emeritus of the Massachusetts General
Hospital, had been called upon to conduct a thorough assessment of the
hospital, which had been stripped of its accreditation and was suffering
under the effects of a disastrous conflict between the board and the
medical staff.
The conflict smoldered as early as 1949 with criticism levied at the medical staff for poor supervision
of its members and lax attention to the interns. In a major blow, the Council on Medical Education &
Hospitals of the American Medical Association failed to approve the hospital for intern training. The new
administration, led by Bernard J. Dolan, chose to abandon traditional communications with the staff and
began devising a plan that would engage a strong physician leader, employed by the hospital, who would
have the power to direct much of the staff’s activities, including selection of medical staff members. The
conflict boiled over in the summer of 1950 when two doctors were accused of malpractice.
Danbury Hospital’s problems were captured in a long article in Modern Hospital magazine.
FROM DARK CLOUDS TO BLUE SKIES, 1950-1960
47
All during the public tumult neither the medical staff nor the
administration took any steps to remove these doctors from the staff
or from the hospital. The malpractice case did not prove to be directly
relevant to the hospital’s problems, but it called the public’s attention to
the lax controls of the medical staff and weak oversight by the community
representatives serving as the Board of Managers. In fact, President Dolan’s
brief annual report of November 1950 failed to make mention of any issues
with physicians and even includes a very positive report from the chairman
of the medical staff.
However, a few months later, in the spring of 1951, the board recognized
the hospital’s lack of control over the medical staff and finalized the new
management plan to hire a strong physician leader. Word leaked out that
Dr. Francis Conway of New York was to become director of surgery and
chief of staff. Not only was he to receive a salary from the hospital, he was
also to be allowed to build his own practice in competition with members
of the staff.
The Storm
B
1 The American College of Surgeons also condemned the arrangement between the hospital and Dr. Conway.
2 Walter G. Merritt worked tirelessly to resolve the conflict. His two detailed reports, signed originals, can be read at the Danbury Museum and Historical Society.
48
attle lines were drawn. Doctors on the medical staff wanted no part
of heavy-handed controls by the board nor did they want a competitor
subsidized by the hospital. Parliamentary fights over by-laws became frontpage news. The board concocted a number of different schemes to pay
Dr. Conway in order to get around the by-laws. The American College
of Surgeons took a drastic step and removed the hospital from its
approved list.
The public blamed the doctors. The doctors took out full-page paid
advertisements blaming the board.1 At the annual meeting workers from
hat factories and other businesses were each secretly given $5 so that
they could instantly become members and vote at the members meeting
to support the board, which they did. The board hired Dr. Conway in
December 1951.
A glimmer of hope shone through in June of 1952 when the board asked
Walter G. Merritt, a prominent attorney who had been trying to mediate
the conflict, to help institute a program of cooperation.2 A ‘peace meeting’
took place and a conciliatory resolution by the board to form a committee
to foster cooperation was enthusiastically accepted by the doctors. The
doctors also liked the section of the resolution that now prevented Dr.
Conway from competing with them.
“Unanimous Action Shows Harmony Restored between Management
and Staff ” read the headline in the Danbury News-Times. However,
harmony was still some way off. The committee for cooperation met only
once. On Aug. 1, Dr. Conway informed Dr. Nathaniel Selleck and Dr. John
Booth, who had been chief of staff, that they were removed from staff service.
Both doctors as well as other medical staff members pressed the board and
Dr. Conway for reasons, but learned nothing.
On Aug. 14, Dr. Conway abruptly resigned and left Danbury, but the
suspensions of the two doctors stood. Dr. Booth said at the time that he and
Dr. Selleck had been vocal critics of Dr. Conway and that he wanted them
gone. One report attributes Dr. Conway’s resignation to a power struggle
and his failure to persuade Mr. Dolan and the board to agree to the removal
of many more doctors.
Physician confusion was building over reappointments to the medical
staff, as was public resentment over the suspensions of Dr. Selleck3 and Dr. Booth. Both men were native Danburians and very popular with their
patients. Neither had been involved in the malpractice case. The dam first
cracked open in October when Dr. Booth, who had completed the first part
of an operation at the hospital, was forced to move his patient and complete
the surgery at another hospital. But the dam burst when the board granted
the special request of a prominent local woman to have Dr. Selleck deliver her
baby at Danbury Hospital but then refused the request of another woman.
Public outrage and reports of bureaucratic wrangling between the two
parties filled area newspapers. On Nov. 13, 1952, the doctors sponsored an
open meeting at the Elks auditorium, where more than 700 people heard
from the doctors. The public in attendance enthusiastically supported a
resolution to get the two suspended doctors reinstated and to engage a
conciliator.
The annual meeting was held three days later. This time the board did not
pack the meeting with phony new $5 members. Those attending voted to
sweep out all the board members involved. Even those not up for re-election
chose to step down.
A new board led by retired Danbury businessman Walter Lenk, with
Walter Merritt also serving, moved quickly to adopt several measures:
• Restore privileges to Dr. Selleck and Dr. Booth.
• Initiate the search for a director with overall authority for all hospital administration.
• Engage Dr. Nathaniel Faxon as a consultant to perform an overall evaluation of policies and practices.
• Rewrite the by-laws.
Walter G. Merritt worked to resolve the crisis.
3 Dr. Selleck was the second of three generations of Nathaniel Sellecks to serve on Danbury Hospital’s medical staff.
49
Modern Hospital magazine revisited
Danbury Hospital with a positive story
later in the decade.
Blue Skies
“Hospital efficiency depends on a precise division of authority and responsibility
among community board, medical staff, and hospital administration. If this
balance is upset - if responsibility is neglected or authority is exceeded in any
corner of the triangle - trouble begins.”
T
4 Dr, Faxon’s full report can be read at the hospital’s Horblit Health Sciences Library.
50
hat quote from an article in Modern Hospital magazine about the
hospital’s troubles recognizes a fundamental truth about Danbury
Hospital. Because of the unique way the hospital was formed, and perhaps
because of the unique character of its population, Danbury Hospital
has always met challenges through a three-part alloy of people from the
community, the hospital, and the medical staff.
The speed with which the hospital recovered from the conflict showed
how well this three-way partnership served the public and the institution.
The new board president, Walter Lenk, was described as a modest, tactful,
community-minded citizen who used diplomacy and good judgment to
restore confidence to all parties. Engaging Dr. Faxon from Boston to
conduct an impartial audit turned out to be an excellent move. Dr. Faxon’s
March 1953 report4 became the perfect platform to move the hospital
forward.
His introduction stated clearly that the doctors and board members
had impressed him by harboring no lingering resentment and in fact
expressed their desire to help in any way possible. He generally agreed
with many who said later that the conflict reflected a disagreement among
people of goodwill over methods to improve the hospital, coupled with a
failure in communication. When Board President Bernard Dolan passed
away in 1952, the board passed a strong resolution of appreciation for his
dedication.
Dr. Faxon found the physical plant to be in good shape and gave very
high marks to the operation of the hospital. He reserved special praise
for Anna Griffin, who he felt had carried out her duties as administrator
impartially while in an extremely difficult position.
One of Dr. Faxon’s goals was to get the hospital back in shape so that
it could have an intern training program and regain full accreditation
from the American College of Surgeons, which was now part of the Joint
Commission on Accreditation of Hospitals. He offered new language
for the by-laws and the establishment of certain committees, but his
major recommendation would completely reorganize the medical staff
and change some of the doctors’ long-standing practices. He felt some of
the older, more generally trained doctors were practicing in areas where
newer, specialized practitioners would provide more appropriate patient
care. He called for sharp delineation of medical staff departments. His list
organized the staff into these clinical divisions:
Medicine
Dermatology, Cardiology, Neurology and Psychiatry
Surgery
Orthopedics; Urology; Ear, Nose and Throat; Eye;
Neuro-surgery; and Thoracic surgery
Obstetrics
Pediatrics
Pathology and lab
Radiology
Anesthesiology
Physical medicine
Dr. Faxon focused on patient care and made firm recommendations.
He provided details right down to which procedures should be performed
by each department and what would be necessary for a doctor to gain
privileges to practice in an area. He stated that Danbury Hospital had
reached a size where providing a high standard of care required such
organizational discipline.
51
Forever Changed Specialty Medicine Arrives
A Tissue Committee was created to review
each surgical case.
The doctors and administrators who were
present at the time of Dr. Faxon’s report
agree today that his recommendations
profoundly changed the hospital. His
key dictum said that doctors should not
be privileged to treat any patient suffering
from any malady just because they are
doctors. The effect was to affirm the
advent of specialty medicine for Danbury
Hospital and the medical staff. Many
doctors on staff strongly opposed the
recommendations and openly showed
their resentment to the first boardcertified physicians arriving in town. This
resentment would peak in the 1960s, but the hospital’s movement toward
more sophisticated medical care, now begun, would never turn back.
A Speedy Recovery
The task of restoring confidence took on myriad dimensions. Two
trustees were required to inspect the hospital each month. A new Public
Relations Committee worked to get a flow of news to the community.
Board President Walter Lenk set up several study committees but much
of the credit for progress fell to his leadership of a seven-person joint
conference committee composed of doctors, board members and the
administrator.
Joint Committee of
Mrs. G. Reginald
Hooper, Walter
Gordon Merritt,
Robert P. Lawton,
Wendell Davis,
Dr. John C.
Murphy, Dr. Fred
C. Spannaus, and
Dr. Frank M.
Goldys.
Horblitt Health
Sciences Library.
52
He called on them to practice a gospel of the four “C’s” — Contact,
Conference, Confidence, and Cooperation.
The speed of the recovery surprised many. By 1953 the hospital was
restored to full accreditation and Blue Cross agreed to cover all services at
the hospital. New clinics were established. The auxiliary was reactivated
and membership jumped from 219 to 1,600 and the members staffed the
new lobby and gift shop.
A new director of the nursing school was hired to salvage the program
and brought admissions back up to 20.
Anna Griffin, the long-time administrator, who bore the operational
burdens of the conflict, resigned and was replaced by Robert Lawton, a
seasoned hospital administrator from Vermont.
By the middle of the decade the hospital was earning a strong vote of
confidence from the public as admissions were rising.
Recognizing the need for the hospital to expand and acknowledging
the improvements, the Rotary Club gave its own vote of confidence by
pledging a large sum for building development. Confidence was bolstered
again in 1956 when the annual report proudly displayed a photograph of
the official certificate awarded by the Joint Commission on Accreditation
of Hospitals, a strong confirmation that the crisis had passed.
Re-certification by the Joint Commission
confirmed the hospital’s progress.
Nursing officers of
1955. Left to right
Rosemary Melvin,
Margaret Connors,
Carole Anderson,
Standing, Dawn
Hellerich.
Danbury Museum and
Historical Society.
53
An early meeting
of the new
Development
Office team.
Seated: Bertram
A. Stroock (chair),
Mrs. Lazarus S.
Heyman, Walter
Gordon Merritt,
Mrs. G.R. Cooper.
Standing: Charles
E. Lauriat (Dev.
Dir.), Joseph W.
Dumser, Albert
E. Hamilton,
Abraham Dick.
Horblit Health
Sciences Library.
A New Focus on Fundraising
From its beginning, the hospital
needed and used a variety of ways to
raise money. In 1957 it created the
Development Office with a full-time
director.
The hospital needed both expansion
and modernization. The centerpiece
of the program would be a six-story,
multi-departmental brick building
attached to the south of the other
buildings. The Development Office,
however, would not exist just for
the building program. The Board
and Administration recognized that
the hospital would need ongoing annual support “to meet the constant
demand of modern medicine for new equipment and facilities.” Modern
medicine in the 1950s encompassed the discovery of DNA, the first
mechanical heart and lung machines, and the Salk polio vaccine.
The South Wing opened in July 1959 with a dedication ceremony
featuring Marian Anderson. The hospital now had 230 beds and 28 bassinets.
Every inch of the pharmacy in 1955 is crammed with drugs. The hospital spent $53,000 for
drugs that year. By comparison, in 2008 the hospital spent $14 million.
54
After a drop in admissions in 1957
the hospital felt obliged to show the
community that activity was again
on the rise.
Outside the Hospital
N
either Danbury nor the rest of the world stood still while the hospital
went through its storm.
Nostalgia fans recall the fifties as a carefree time of Ike, Elvis, James
Dean and great looking cars, but in fact, it brought a somber side now
often overlooked. The decade opened with the Korean War and U.S.
H-bomb tests on Bikini Atoll. In Groton the Navy launched the first
nuclear submarine and in our homes and schools we practiced bomb shelter
drills. The hunt for communists temporarily took center stage but the
Soviet Union’s launch of Sputnik, the desegregation of schools and the civil
rights movement became the longer-lasting stories.
Polio continued to ravage the U.S., peaking in 1952 with about 60,000
cases. It produced the worst national epidemic since 1918. It was not
uncommon to visit a friend in an iron lung.
For Danbury, the 1950s brought both growth and disaster. On Aug.
13, 1955, a storm named Connie dropped six inches of rain on the area in
record time. Just six days later, hurricane Diane pounded the region for
two days with 14 inches of rain. And it wasn’t over. Between Oct. 15 and
Oct. 16 another storm flooded the state. Almost every photo album in
every home in the region has photographs of the devastation.
But the 1950s will also be remembered for the area’s extraordinary
growth. Population jumped 33 percent to more than 40,000 in Danbury
and 75,000 in the region, and a real estate boom was on. Very significantly
for the hospital’s future, it was becoming a time of industrial expansion.
BIRTHS
1400
1300
1200
1100
1000
1960
1950
10000
ADMISSIONS
9000
8000
7000
6000
5000
1960
1950
55
56
The great 1955 floods.
57
Chapter 6
Challenge and
Change Accelerate
1960-1970
58
C
onventional wisdom says that the tumultuous 1960s were a reaction to the conformist, laid-back 1950s. The
’60s began with the election of a young President John F. Kennedy
and hopes for an American “Camelot.” Instead, the next 10 years
accelerated through one dramatic event after another. The Berlin
Wall went up and Fidel Castro took power in Cuba. The Soviet
Union installed missiles in Cuba, bringing the world to the brink
of nuclear war, and a year later President Kennedy was assassinated.
A six-day war erupted in the Middle East and a small military
support operation mushroomed into the Vietnam War, dividing the
nation. The Civil Rights Movement spawned riots and marches and
awakened society’s conscience. America’s emotions took another
blow when both Sen. Robert F. Kennedy and the Rev. Martin
Luther King were assassinated.
By the time the decade roared to an end, birth control pills and a vaccine
for polio were widely available. An American had walked on the moon
and 15,000 young people were Peace Corp volunteers, while nearly half a
million of their peers had celebrated at Woodstock.
The Danbury area and Danbury Hospital felt the full force of that acceleration in the 1960s.
Interstate-84 and good economic times attracted more than 60 companies to the area. Beginning in
the late 1950s, the new arrivals included Viking Wire, Heli-Coil, Davis & Geck, Eagle Pencil, Branson
Power, and National Semiconductor. The Danbury economy grew by 10,000 non-hatting jobs.
CHALLENGE AND CHANGE, 1960-1970
59
Eagle Pencil Company
was an early corporate
arrival to the area.
Danbury Museum and
Historical Society.
Manufactured products included precision ball bearings, surgical
instruments, gun sight equipment, cosmetic containers, oil burners, pens,
pencils, shirts and children’s wear. Many of the new industrial plants
including Preferred Utilities, Consolidated Controls, Republic Foil, Sperry
Products, and Connor Engineering located in the southeastern or Shelter
Rock part of Danbury.
With the new South Building now open, it might have seemed that
the hospital could look ahead to a few years of smooth, steady times, but
instead the hospital underwent an important acceleration of its own as
more board-certified specialists and sub-specialists joined the medical staff.
These new, highly trained doctors attracted others. No understanding of
Danbury Hospital can be complete without appreciating the importance of
this dynamic. When these 1960s newcomers are asked today: “Why did
you come to Danbury Hospital?” the overwhelming response is “I came to
Danbury Hospital because I knew a doctor on staff here. I respected him
and so when he suggested that I join him I took a good look. I liked what
I saw and I joined.”
Over time, as the influx continued, other physicians decided to come to
Danbury because they saw a growing, well-trained group of doctors with
whom they wanted to work. Of course, it helped that the Danbury area
was a desirable place to live. The fact that they moved into the local towns
further deepened the connection among the medical staff, the hospital and
the community.
Partly because of the new specialists and partly because of the changes
in technology, the hospital undertook several upgrades to the laboratory
and radiology departments. The intensive care unit now functioned
well and a new six-bed recovery room provided some post-operative care.
Electroencephalography and electrocardiography arrived early in the
decade and physicians were introducing new techniques such as flexible
60
sigmoidoscopy. The hospital created residencies in surgery, radiology and
general practice, and the internship program was renewed.
In 1962 the hospital received an unusual bequest: The BrewsterMeckauer Convalescent Home. That year’s report explained it.
The Brewster-Meckauer Annex
A convalescent and residential care facility known as the Brewster-Meckauer
Annex of the Danbury Hospital has been established. This much needed
program of medically supervised convalescent care has been made possible
through the joint efforts of the Danbury Hospital, The Amelia Brewster Home,
and the Henry Meckauer Trust. This new hospital program is particularly
worthy of generous community support.
For the next 20 years the hospital struggled to figure out what to do with
the convalescent home. A plan to move it near the hospital stayed alive
when land belonging to the original Meckauer estate in Bethel was sold
and the money added into the trust, doubling its income, but the venture
continued to run in the red. Later that trust money would be used to buy
land next to the Brewster Home on Main Street to make it more attractive
to sell when the hospital implemented its plan to move the home1.
1
The plan never developed. The money in the trust remained there until 2004 when 90 percent was awarded to Danbury Hospital’s Development
Fund and 10 percent to the Bethel VNA.
The capping ceremony for the 1961
graduating class. Front row from left,
P. Tallman, M. Reynolds, P. Rowan, S.
Grouse, N. Russell, S. Garrison. Back
Row, F. Petersen, M. Pogany, G. Ferriss,
P. Maher, M. Corbett, S. Haitsch, M.
Maruses, M. Maruscsak, A. Moissonnier.
61
Growth Brings Problems
P
The long-range planning objectives for
1961 were made clear to the community.
62
eter Pierdinock, the hospital administrator; Walter Van Lenten,
president; and Dr. Dean Edson, chairman of the medical staff, early in the decade use the word “problem” to describe the hospital’s situation.
Hints of the problem showed up first as facility overcrowding. Slowly it
became a shortage of equipment and then a shortage of personnel as admissions grew.
Adding to the hospital’s problem
were its losses from operations. Not surprisingly, the board formed a Planning Committee. The committee produced a three-year plan of expansion and improvements called the
“Blueprint for Progress.”
The price tag was $1.2 million,
requiring a target of $750,000
to be raised. The Development
Committee temporarily became
the Progress and Development
Committee.
Doctors soon formed their own
Medical Progress Committee to
advise and support the hospital
on growth. The Committee
became one of the most significant
organizations in the hospital’s
history. Doctors spoke out on what
they saw as needs. While they were
calling for urgent expansion, the
administration was cautious and
slow to respond, citing trade-offs
and limited resources.
With 80 percent of the public becoming insured and able to seek care,
the crowding, shortages and malaise at the hospital grew worse and, in
1965, a new plan was developed. Declaring that “We must eliminate the
doubts and uncertainties about the future,” the plan was announced in a
multi-page brochure. It called for a new four-story building along with
renovations to older spaces. In dramatic fashion, the brochure declared:
“The Emergency Department must quadruple. Surgical space should be
tripled, X-ray must triple in size. Outpatient clinics must grow five times as
large. Laboratories must triple their space. As medicine grows better and more
complex the pressure is unrelenting!”’
The Department of Physical Medicine and
Rehabilitation was moved from the nurses’
residence area to a fully renovated section
on the fourth floor of the Center Building.
The price tag for the new plan jumped from $1.2 million to $4 million.
Early public reaction fell short of expectations. The Development
Committee called for more volunteers and decried a seemingly indifferent
public. A new Public Relations Committee worked for a coordinated
image and tried advertising, meetings, and direct mail, but finally folded
itself into the Development Committee.
The mid-point of the decade brought other dramas. The hospital
weathered the great power blackout of the Northeast and responded well
with its disaster plan when two airliners collided over nearby New York
State. After 86 years, the hospital closed its nurses’ training school. The
students went first to Stamford Hospital then, in 1966, Danbury State
Teacher’s College opened its four-year nursing program and accepted its
first class.
63
Several key people arrived on the scene during this time. Dr. Nilo
Herrera, who would impact the hospital’s medical education; John Creasy,
who would become administrator and then president; and Bertram Stroock
who, along with his wife, would add enormous power to the hospital’s
philanthropy.
During 1966 the hospital faced a mountain of challenges. The new
doctors had poor and inadequate space to practice. A nursing shortage left
operating rooms running at partial capacity and the delays in treatment
hurt the hospital’s reputation. The surge of new companies to the area
grabbed up all the other labor supply. The stiff competition for labor
required the hospital to update its wages and salaries and to install a
pension plan, all while it was losing money.
Bertram and Margaret Stroock.
Medicare Arrives
Medicare arrived in July of 1966 and brought more new and older
patients. Medicare not only paid its bills late, but it based payment on
historic expenses -- and the 1960s was a period of severe inflation. Even
worse, Title XIX, the forerunner of Medicaid, reimbursed from a lower
and more confusing payment schedule. Doctors also saw lower fees.
New committees were needed to address regulations and to perform
newly required utilization review, all of which distracted the board, the
administration, and the medical staff. And, on top of everything else,
money for the expansion project was not coming in.
Overcoming these challenges required major changes and a new,
aggressive approach to growth. The administration worked on cost
reduction and improved efficiency, which led as far as termination of some employees.
The Long Range Planning Committee, with advice from the Medical
Progress Committee of the medical staff, reviewed its expansion
program. The result was not a reduction but a dramatic expansion
of the building program that would truly address the future. Both the
doctors and a new administration under John Creasy felt that past
timidity had been partly to blame for the situation. Deciding on the
largest expansion in its history while facing all the other challenges
was a bold step. The cost was now estimated at $12 million —
three times the old plan.
64
The facilities redesign
FROM THE DEVELOPMENT AND EXPANSION REPORT
itself took little time, but
the issue was money. Led
HERE ARE THE PLAIN FACTS
by Bertram Stroock, the
• The new Diagnostic and Treatment Center must be built and equipped
hospital overhauled its
• The population of the area is rising by 5% a year
Development Committee
• More older people are using the hospital under Medicare
activities. Sharing the dollars
• Medical equipment is becoming more complex and its cost is in the Community Chest still
constantly increasing
did not meet the hospital’s
• More emergencies and outpatients are being handled
needs. Believing that the new
building plan was an excellent
In fact, at least fifty thousand people, or approximately fifty percent of our
project for the health of the
area population have used Danbury Hospital in one way or another this last
community, the committee
year, but only a small number have volunteered their money or their help.
launched an aggressive public
campaign. But the real
LETS FACE IT
success came from a new
• Danbury Hospital needs $800,000 in donations a year to progress.
approach, one that sought
large “pace setter” gifts. The
many new corporations in
TO RAISE IT WE MUST
the area proved to be a great
• Broaden the base and obtain moral and financial support of many, source for Stroock and the
many more individuals in the hospital area.
Development Committee,
• Broaden the center and get more help from industry, organizations, and would stand as the model
and townships.
for future fundraising.
Stroock and his committee AND, ABOVE ALL, RECOGNIZE THE VITAL NEED FOR
co-chairman Rolf J. Thal,
ADDITIONAL LARGE “PACE SETTING” GIFTS
Executive Vice President of
Eagle Pencil Company, pulled
no punches in their annual report the following year.
ADMISSIONS
“With determination, dedication, and hard work, our goal can be met, but we need evangelizing zeal to bring more and more good men and women
into active participation in the service of Danbury Hospital, both as workers
and contributors.
Only if we can draw the full human resources in the area, only if we have
agreement that doctors, nurses, staff, technicians, volunteers and trustees form
a team serving the most vital institution in the community, only if we can
convince our neighbors throughout this area that this is their hospital, their only
retreat in times of serious injury and illness, will we be able to raise the dollars
to finance the needed growth and development.”
13000
12000
11000
10000
9000
1970
1960
Admissions soared during the 1960s
65
Dr. Nilo Herrera
“Nilo was the beginning. He was the beginning and the early
physician leader of the transition of Danbury Hospital from a
community hospital to an academic teaching center. He was
devoted to the science of medicine and, in fact all science. As most
people know, his background included an escape from the Dictator
Trujillo, a feat that took courage and determination. Nilo used that
unwavering self assurance to continually – and successfully influence as many members of the medical staff as he could reach
to engage in medical education and advancement. He was also the
most effective medical politician I have ever known. His success
continues to benefit the people in our community.”
Nelson Gelfman, M.D.
Past President, Danbury Hospital Medical Staff
“Nilo was ahead of his time. The Lab and medical education were his major thrusts,
but we should also remember that he was a great student himself; restless, always
learning and planning. His expertise in Nuclear Medicine was learned on the job,
taking courses and reading. While he learned nuclear medicine he organized an
“International Symposium” at Danbury Hospital and invited recognized experts to
speak. Afterward he obtained a donation of equipment and started the Nuclear
Medicine Department. He put Danbury Hospital, for the first time, in the national and
international spotlight.
I also remember that when he and his wife Clara took the floor to dance, everyone
cleared off and applauded; they were smooth performers!”
Joseph Belsky, M.D.
Attending Physician at Danbury Hospital
“Dr. Nilo Herrera was everybody’s patriarch. He initiated debates and stimulated
minds. If you had a quandary or dilemma, Nilo was the man you went to see. He
often stood outside his office just to be more accessible and sometimes just to grab
doctors as they walked by. He corralled anyone who he thought he could get to teach.
He had a soft, Dominican lilt to his voice and was always helpful, but when he wanted
something, he was a tiger. His zest, intellect, and positive influence shaped the
hospital of today.”
Philip Kotch, M.D.
Past Chairman, Department of Surgery
66
Dr. Raphael Schwartz, center, and Dr. Victor Machcinski with their students.
The Specialists Arrive
The doctors who arrived at this time became
The effort brought results. Those results, along with grants and a
favorable financing package, assured the project’s viability. Ground
was broken for a four-story Diagnostic and Treatment Center in 1968.
The D & T Center, as it was known, provided major steps forward for
the Emergency Department (first floor), the Laboratory (second floor),
Radiology (third floor), and surgery which now had the fourth floor for
operating rooms.
The hospital did not come to a stop while it developed plans for expansion,
acquired land, and arranged financing. Its educational role took on new
importance and time was devoted to grand rounds, in-service education and
off-site conferences. Dr. Raphael Schwartz assumed the role of Director of
Medical Education from Dr. Victor Machcinski in 1961 and held that parttime post until Dr. Joseph Belsky assumed the role full-time in 1965.
In addition to its intern and residency programs, the hospital added or
expanded training in Medical Technology, Radiographic Technology and
Nurse Anesthetists.
One of the hospital’s earliest efforts at medical education involved the
radio. In the early 1960s Albany Medical Center and Albany Medical
College broadcast over the Albany Radio Network. Doctors here in
Danbury would gather around the radio, usually at lunch time, and listen
to grand rounds lectures that satisfied certain continuing medical education
requirements.
Most who remember the period give special recognition to Dr. Nilo
Herrera, who from his position as director of the laboratory, came to
champion medical education at Danbury Hospital for four decades. Dr.
Herrera began to build on the teaching relationships that a few doctors had
with Yale Medical School and Yale New Haven Hospital. It’s axiomatic
synonymous with Danbury Hospital in
the decades that followed. This list is a
representative sample of those physicians
who contributed to the quality of patient care
and to the hospital’s success.
MEDICINE:
Raphael Schwartz, M.D., Paul Coleman, M.D.,
Charles Mauks, M.D., Paul Kunkel, M.D.,
Joseph Belsky, M.D., Peter Pratt, M.D.
SURGERY:
Henry Blansfield, M.D., Robert Grossman, M.D.,
Jack Orr, M.D., Parviz Mehri, M.D.
PEDIATRICS:
Thomas Draper, M.D., Alvin Goldman, M.D.,
Robert Joy, M.D., Martin Randolph, M.D.,
L. Robert Rubin, M.D., James Sheehan, M.D.
ORTHOPEDICS:
William Sinton, M.D., Robert Fornshell, M.D.,
Frank Saunders, M.D.
OBSTETRICS AND GYNECOLOGY:
Guido Gianfrancheschi, M.D.,
Morley Goldberg, M.D., Ed Kuczko, M.D.,
Marjorie Shafto, M.D.
Interested readers are encouraged to learn more about
these and other early physicians by visiting the hospital’s
Horblitt Health Sciences library.
67
that while teaching at an academic center such as Yale, the teaching
doctors also learn and stay current in the latest medical science. Dr.
Herrera and Dr. Belsky knew those doctors would bring that knowledge
back to Danbury Hospital and they began to actively encourage
these teaching assignments. The axiom also held for doctors teaching
Danbury Hospital’s own residents. Teaching meant that doctors had to
stay current. There was no room for the status quo.
Danbury Hospital changed also because of other major forces affecting
medical education. The GI Bill had provided for veterans to attend
college and further provided those veterans who became doctors with
subsidized medical residency experiences. The government granted and
then increased a separate subsidy to hospitals offering those residencies.
Later, embedded in Medicare, were new entities called Regional
Medical Programs (RMPs.) RMPs were conceived as a “Great Society”
project of the Lyndon Johnson administration. Their goal was simple:
bring high-quality medical care to the American people by linking
health research and education with community health needs on the
regional level. The founding legislation directed that centers of excellence
be created, encompassing medical schools, research institutions, and
hospitals. By creating these cooperative arrangements, funds were now
available to Danbury Hospital for continuing research and education,
including the development of added residency training programs and,
most importantly, hiring and paying doctors to teach.2 Danbury
Hospital would now become a true teaching hospital.
Those interviewed for this book, without exception, mark this period as
one of the most important in the hospital’s history.
Turmoil in the Medical Staff
The hospital worked at building a positive
image of its service to the community.
2 Over the years Medicare made many adjustments to its formula for subsidizing graduate medical education (GME.)
68
Not all doctors were as eager as others to embrace the new emphasis
on education and specialization. Many of the older “apprentice-trained”
doctors saw threats to the status quo of both their leadership and their
financial well-being in the hospital’s sponsorship of the new trends. As
a response, the medical staff formed 18 different committees, essentially
to parallel the hospital’s efforts. While doctors served on the hospital’s
committees, no hospital members were permitted on the medical staff
committees except for John Creasy, the administrator, who served on
the Medical Progress Committee. The archives suggest that the medical
staff pursued two agenda items. One was to encourage the hospital to
aggressively expand. The medical staff offered substantial advice and
pledged support in raising funds.
The second medical staff agenda item appears to have been less
benevolent. The leadership of the medical staff may have been encouraging
the hospital to expand, but it was also busy enforcing barriers to the
board-certified newcomers. New doctors were generally given undesirable
assignments. They were largely restricted from practicing without a senior
member’s close supervision. On occasion they were called on to assist in
procedures for free as “training.’’ In more than one case a new doctor was
told in what town he could open his office.
This second agenda certainly offended the new doctors, but it also ran
contrary to the hospital’s chosen course as a full teaching hospital. For a
short period, a group of mostly newer doctors and the hospital remained
the nexus of the Danbury Hospital Medical Staff while another, mostly
older group moved off in opposition and attempted to form the Danbury
Medical Association Staff. Conflict was brewing again.
It is debatable what prevented a repeat of the blow-up that occurred
in the 1950s. One factor was a determined administration, backed by a
community-supported and well-defined plan developed by the Board of
Directors. The very size of the hospital and its undertakings created a solid
forward inertia. The second factor came from within the medical staff.
Centered in the Department of Surgery, a group of newcomers banded
together to elevate Dr. Joseph Cherry, one of their own, first to senior status
and then to chief of surgery. The balance of power was shifting as new
doctors arrived and senior doctors retired. New leaders of anesthesiology
and radiology joined alongside the successful new leadership in the
laboratory. The hospital added to the transition by hiring doctors such as Dr. Belsky directly onto the hospital payroll 3.
Dr. Joseph Belsky was hired directly onto
the hospital payroll.
Beyond Danbury
Dr. Joseph Cherry
Family Photo.
T
he 1960s marked the beginning of regionalization of health care and
hospitals. Encouraged by legislators and the area’s selectmen, who were
now ex-officio trustees, Danbury Hospital became part of the Connecticut
Regional Medical Planning Committee. An early goal of the committee
involved avoiding duplication of services, a philosophy that would impact
the regulation and rationalization of Connecticut hospitals from that time
forward.
The hospital began a practice of mentioning all the towns it serves in each
annual report. It called for special coordination among Danbury, New
3 The program of hospital-employed doctors will be an ever-changing issue for many years to come.
69
Milford, and Putnam hospitals. Annual reports in 1968 and 1969
mentioned the hospital’s goal of becoming “the area’s comprehensive
health service center coordinating with others by providing acute,
chronic and ambulatory care.” It began positioning itself as a
“teaching facility for medicine, nursing, and related technologies.”
The Visiting Nurse Association was presented as a partner.
Other new terms entered and changed the hospital’s vocabulary.
Along with words like “regional,” “teaching facility,” and “efficiency”
the hospital reported on “patient-centered care,” and “community
stewardship,” and declared a “partnership with the community.”
In fact, one annual report contained a four-page personal Medical
Health File with instructions for its completion. The hospital urged
people to bring the file when they visited a doctor or the hospital so
that together they recorded the medical history of every member of
the family. Extra copies were available upon request. The hospital
conducted patient satisfaction surveys and developed its first employee
communications program.
By the end of the decade the hospital’s
objectives adopted a more operational tone.
A Growing Reputation
The hospital was keen to let the public know that it was an up-to-date
medical facility, and that it was responding to the trend toward hospital
generalization by adding services such as those for mental illness and
infectious diseases. The hospital could justly point to three new patient
care innovations it pioneered during the 1960s, each of which captured
attention across the state and beyond.
Nuclear Medicine
The first was nuclear medicine. Led by Dr. Herrera and with the aid of
grants and gifts from the Atomic Energy Commission and Perkin-Elmer
Corp., the hospital established the service in 1963 to treat cancer with
radiation. By 1966 the hospital was able to host a symposium on nuclear
medicine that attracted faculty and participants from all over the U.S. and
from Canada. The service was not available in most community hospitals.
Full-Time Emergency Department Doctors
Dr. J. Benton Egee.
Family photo.
70
The second was a revolutionary way to organize the Emergency
Department. Up until that time, emergency departments were staffed
on a rotating basis by members of the medical staff, some of whom were
less than expert in treating emergency cases. Dr. J. Benton Egee, who
practiced in Newtown, conceived of an Emergency Department staffed
with full-time, specially qualified
physicians. After overcoming
some uncertainty and resistance,
the first program of its kind in
Connecticut went into effect
in Danbury Hospital in 1965
with five full-time doctors on
staff under Dr. Egee’s direction.
Emergency volume went from
15,000 cases the year the
program opened to 35,000 by
1969. It proved successful from
the beginning and added to the
hospital’s growing reputation.
Renal Dialysis
The third was renal dialysis. The Yale School of Medicine had
established a renal dialysis program under Dr. Howard Levitin when
Danbury Hospital’s doctors began their teaching relationship there. Dr.
Nelson Gelfman and other Danbury Hospital staff felt the hospital could
develop such a program here. New surgeons with new skills were now on
staff and the hospital’s laboratory had become very sophisticated with inhouse experts in each section. A Committee on Renal Dialysis was formed
and with a letter of support from Yale’s Dr. Levitin, the committee made a
proposal for two artificial kidney units and a staff of three. The proposal
was accepted and with the support of a donation from the Rotary Club,
the unit opened in 1969. The unit drew strong community support and
wide attention and added to the hospital’s growing reputation for providing
up-to-date care.
Danbury Hospital began the 1960s as a traditional community hospital.
By working together, the community, the administration and the staff
transformed it into a hospital that served a much broader region and one
that exercised its stewardship with 15 clinics for those unable to afford
private care. The hospital had introduced highly advanced services such as
nuclear medicine, dialysis and a 24-hour staffed emergency department.
Most significantly, Danbury Hospital started on its course as a full teaching
hospital committed to providing the most modern medical care to the
people it served.
At a later renovation of the dialysis
unit, Bertram Stroock, right, thanks
Joseph Howard of the Connecticut
Kidney Foundation for their support.
Drs. Nelson Gelfman and Howard
Garfinkel look on.
71
Chapter 7
The Modern Hospital
Takes Shape
1970-1980
72
T
he corporate movement of firms into the area continued with the arrival of Grolier, Boehringer Ingleheim, Ethan
Allen and others. The biggest impact by far, however, was made
by a firm that wouldn’t move in for several years. Union Carbide
Corporation’s announced move to Danbury sparked a predictable
flurry of real estate activity, but it also caused the city and
surrounding towns to conduct thorough reexaminations of their
capabilities to handle the impact on schools, roads and other services.
Route 7 remained under its never-ending cloud of contention with
more time spent in courts than on construction.
Route 7 and the Union Carbide move were not the only stories that
dragged on for years. The opening of WestConn’s Westside campus
and the replacement of the Danbury Fair with a shopping mall would
also be put off until the 1980s.
Nationally our attention focused on gasoline shortages, Kent State, the end of the Vietnam War,
Watergate, the resignation of one president and the attempted assassination of another. For a time we
endured lines at gas stations. By 1976 we put that behind us and celebrated the nation’s bicentennial with an outpouring of patriotism not seen in years.
The people of the area tried right up until the end to hang on to the Danbury Fair.
THE MODERN HOSPITAL TAKES SHAPE, 1970-1980
73
The Pardue brothers enjoyed only one
month of freedom after their Danbury
crimes.
1The amount may have been as little as $25,000.
74
While the Vietnam War was
over, new threats that would change
the world had emerged. Militant
fundamentalists assumed power
in Iran and took 70 Americans
hostage; the Olympics were marred
by a terrorist attack.
Roe vs. Wade was decided. The
laser, the microchip, the CAT
scan and the VCR saw widespread
application, and e-mail was born.
Balloon angioplasty arrived on the
plus side of new technology, but a
nuclear meltdown at Three Mile
Island reminded us that scientific
innovation also brings new
challenges.
Meanwhile, people here said
goodbye to the Beatles, mourned
Elvis and crammed into movie
houses to see The Godfather and
Rocky. We dug out of a snow storm
that shut the whole state down
for three days. Danbury made
the national news several times
during the 1970s. Our Federal
Correctional Institution became the home of the famous Watergate schemers and some well-known antiwar activists.
Hunger strikes and protests at FCI made the papers but the big story
involved the fire at the prison that killed five people. Another tragic fire took place in the Beaver Brook section of Danbury where eight
children perished.
By far the most covered story to come out of Danbury in the 1970s
involved two bank robbing brothers, John and James Pardue. On Feb. 13,
1970, the two set off bombs at police headquarters, a parking lot, and at
the Union Savings Bank office, where they made off with $55,000.1 Both
were caught in March. John Pardue would later confess on his deathbed to
involvement with five bank robberies and five murders, including those of
his own father and grandmother. James hung himself many years later.
Danbury Hospital
N
ew businesses and the desirability of the area fueled the pace of
growth and kept the pressure on Danbury Hospital. Planning became
a dominant activity. The hospital devoted the cover of the 1970 annual
report to the importance of planning.
Administrators, trustees, and doctors mostly did a fine job,
especially with the hospital’s facilities, but forces originating
outside their line of vision created huge burdens on the
hospital’s time, money, and focus.
The 1970s began with the hospital perfecting the recently
completed four-story Diagnostic and Treatment (D&T)
Center. Brought on by additional services in detoxification
and psychiatry, beds were added to the South and West
buildings. Early in the decade the plan for the biggest change
in the hospital’s capacity and appearance had been approved;
a seven-story, fully air-conditioned tower would be erected
above the four-story D&T center, bringing the capacity of the
hospital to more than 400 beds.
But a lot would happen between that plan and the finished
construction. The first roadblock occurred in 1971 when
President Nixon’s National Economic and Stabilization
Act froze wages and prices. The major impact landed on
the finance department, which had to coordinate a timeconsuming hospital-wide restatement of all accounting
records. Third-party payers like Blue Cross, in a glimpse
of what would later become managed care contracts,
began to assert power by requiring the hospital to seek approval for all
price increases, including those for new and planned services. The most
significant and lasting event was the establishment of the Commission
on Hospitals and Health Care (CHHC), better known as the Cost
Commission. The Cost Commission exercised approval authority over
changes and additions to facilities, capital equipment, and services as
well as budgets and prices. In addition to the demands of the Cost
Commission, the hospital faced a federal requirement to participate in
elaborate and coordinated regional planning as a part of Region V of the
Health Services Agency.
The hospital labored under all the new regulation and demands to justify
its plans for growth and financial soundness.
The cover of the 1970 annaual report
provided a sharp focus on planning.
75
“The Industrialists”
The executives of the
larger local companies
exhibited strong community
involvement. The heads
of companies such as
Barden, Heli-Coil, Eagle
Pencil, Connecticut Light
& Power, Viking Wire and
others met frequently to
discuss common issues
and community needs.
One effort, during an acute
shortage of skilled craftsmen,
resulted in the cooperative
development of an area-wide
apprenticeship program.
The group, known informally
only as “the industrialists,”
provided exceptional support
to the hospital. Many of
its members served as
hospital chairmen, officers
and trustees and led
Development Fund efforts.
These community leaders
also made a major impact
with their collaboration
on the hospital’s planning
work. Their business
experience with planning,
capital budgets, regulations,
facilities development and
government relations were
called invaluable by John
Creasy, who was president
during that period.
76
The hospital
made a strong
appeal for
community
support for the
new Tower
Building.
Horblit Health
Sciences Library.
Once again the community provided strong support and helped win
approval for the tower project, but a CAT scanner would take years to gain
approval. At one point the hospital sued the Cost Commission when it
denied a rate increase. The matter was settled, but created more distraction.
In his annual report in 1976 President John Creasy said, “From a
management point of view, this past year has been dominated by hearings,
inspections, budget reviews, cost analysis, more hearings and an ever increasing
- oft times overwhelming - involvement with government agencies and the
mind-boggling and time-consuming paperwork such agencies appear to live by.”
He went on to say that it had still been a good year because the community
had rallied together to accomplish the goal.
The new agencies and regulations prompted major changes in the
hospital organization. Concerned that these new agencies would take
control of its philanthropic efforts and money, the hospital spun off the
Development Fund as a separate non-profit organization. The board also
felt the need to revise the hospital by-laws, establishing the administrator as the president and creating several hospital vice presidencies.
Almost all those who were involved with the hospital at the time agree
that the most important changes organizationally revolved around the
hospital’s continuing drive to establish itself as a full-fledged teaching
hospital, with its related growing sophistication. New and more
formalized associations were reached with New York Medical College,
Yale School of Medicine and Yale New Haven Hospital. The board, the
administration and the medical staff all recognized the great value to be
gained by becoming a teaching hospital. When doctors teach they must
stay up-to-date on the latest developments in medicine and they bring that
knowledge and skill back to the hospital. A true teaching hospital can
create better programs for its own resident physicians-in-training and can attract higher-quality people into its residencies.
Well-trained doctors often consider association with
a teaching hospital important when deciding where
to practice. Danbury Hospital recognized that all
the features and benefits of a teaching hospital would
result in better care for the community,2 furthering its
mission.
At the same time, the hospital was becoming more
sophisticated by creating or substantially expanding
many of its programs. Cardiology, physical medicine,
pulmonology, detoxification, community medicine,
infectious diseases, surgery, outpatient services3 and the emergency room
all underwent transformations. New doctors were hired either part time
or full time by the hospital to direct these services. Both the hospital and
the medical staff realized that the somewhat loose organization of the past
would not be effective and so created a formal organization structure to
better manage the expanding number of departmental chairs and section
chiefs. Eventually the hospital, with the concurrence of the medical staff,
hired a vice president of Medical Affairs to coordinate the new structure.
Cardiologist Dr. David Copen delivering
one of his early lectures to residents Dr. William
Gemmell, Dr. Ava Joubert and seated,
Dr. George Iannini.
2 A major community benefit of a teaching hospital results from the fact that many of the newly trained doctors remain to practice in the local area.
3
Because its inpatient beds could not keep up with the rapid growth in population, and because of innovative
physicians, Danbury Hospital became a leader in developing outpatient services.
The Department of Radiology
L
ike other parts of the hospital, the Department of Radiology had undergone some factional turmoil in the
1960s. In 1968 when Dr. William Goldstein arrived to head the department, he began a restaffing program and
introduced around the clock on-site coverage, a unique feature at the time. Soon, the department established
weekly consultations with members of the staffs at Sloan Memorial and Yale. During the 1970s, beginning with a
cobalt machine, the department initiated the process of constantly upgrading its equipment to stay at the forefront
of technology. Also at this time the department added radiologists, many Fellowship trained, with specialties in
radiation oncology, neuroradiology, and special procedures.
The addition of these skilled radiologists not only increased the department’s capability to provide high quality
support, it also added to the hospital’s image as a good place to practice medicine. Doctors considering locating
to the area were positively influenced by the availability of modern radiologic services. Donors, too, recognized
the department’s competence and provided substantial donations to support it.
Radiology equipment undergoes rapid evolution and development, so rapid that at one point the first CAT scan
machine was so new that it was actually assembled on site in the hospital. In a recent interview, Dr. Goldstein,
now retired, reflected on the changes over his 40-year career.
“Technology was always changing. We went from crude chest X-ray machines, to the first ultrasound, to CAT and then MRI
machines. Each new version was more complex than the last, and that’s going to continue. But what we must remember is that
it’s the people that are important. It’s the well-trained, caring doctors and others in the department who stay current in the latest
knowledge and techniques that provide those important services.”
77
One of the many dedication events
for the new Tower Building involved
Governor Ella Grasso. Hospital
Chairman John Hoffer looks on.
No ceremony was held when these buildings, the last remnants of the original
hospital, were taken down.
1970-1979 Emergency Statistics
EMERGENCY ADMISSIONS
70000
65000
60000
55000
50000
45000
40000
1979
1970
At one point during the 1970s,
emergencies plus basic care visits swelled
the volume to more than 65,000.
78
The transformation into a full teaching hospital, now with residencies in
dentistry, obstetrics, psychiatry and dental medicine, and the development
of sophisticated services with a functioning medical staff organization set
the stage for Danbury Hospital’s modern era.
However, the path to modernity had a few bumps. For a few years the
hospital referred to itself in its communications not as Danbury Hospital
but as “ Your Community Health Center.” That temporary appellation
disappeared but another, more substantial name issue involving the
Emergency Room would last for years. As Emergency Room volume
increased, operations divided naturally into those treating patients with
true emergencies and those treating patients with less serious conditions.
The name evolution of the department reflected the reality that much of
the volume had become basic care. The name changed from “Emergency
Room” to a dual “Emergency Room and Primary Care” and then to simply
“Primary Care Department.” For a time, a plan existed to bring all the
growing outpatient clinics and services, including the Emergency Room,
under one departmental heading of “Ambulatory Care Services.” The
plan was never implemented and the decade ended with the dual name:
Emergency Room/Primary Care Department.
The name changes and volumes reflected an underlying issue in the
community. The number of primary care and family physicians had not
kept pace with the growth in population, so more and more patients,
The Hospital and Public Health
P
Danbury at that time was anxious
to have its people properly
served, especially in the field of
communicable diseases. The
city and the hospital agreed to
establish a joint Office of Public
Health that would be located in the
• Assessing and monitoring hospital. Dr. Thomas Draper, who
the health of communities and was Danbury’s health director and
populations at risk to identify the director of the Pediatric Clinic
health problems and priorities;
became the director of this new,
• Forming public policies designed collaborative office.
The results of the health needs
to solve identified community assessment pointed to two issues:
health problems and priorities;
education and access to care.
Access to care for the more needy
• Assuring that all populations have access to appropriate and patients was shifting away from
community physicians and toward
cost-effective care, including the hospital’s several clinics. That
health promotion and disease-
reality continues to influence the
prevention services, and hospital’s operations today.
evaluation of the effectiveness To improve access to care for
of that care.
older members of the community,
the Office of Public Health
The very active Progress
established a geriatric clinic.
Committee of the 1960s evolved
into the Medical Affairs Committee The first effort at education was
aimed at sexually transmitted
and in 1970 advocated that public
diseases (STDs) and resulted
health become a part of Danbury
in establishing an STD clinic in
Hospital’s mission. A committee
1972. This confidential clinic,
within the hospital was formed
run in collaboration with the
to examine the health needs of
Visiting Nurses Association
the community. It based their
(VNA) to provide continuity of
needs assessment in large part
care, became a model. Later,
on what the committee members
observed in the Emergency Room4, using the same model, the Office
of Public Health took over the
the Outpatient Department, and
state-run tuberculosis service
the Pediatric Clinic. The city of
ublic health focuses on the
health of the community as a
whole. Public health is community
health with these three core
functions:
Dr. Thomas Draper a pioneer in community
and public health.
and established a TB clinic. The
hospital’s multi-disciplinary
resources soon established the
TB clinic as an efficient regional
service. TB is a growing health
issue and the clinic continues
to function as an important
community service.
The Office of Public Health, now
based in the hospital’s Seifert and
Ford Community Health Center, has
dealt with outbreaks of hepatitis
and salmonella. It has been a full
participant in achieving a superb
community record of immunization.
Working with school nurses, it
helps children comply with their
needs to take medications. More
recently it has been engaged in
plans to address such community
threats as anthrax and flu-like
pandemics.
4 A full examination of the Emergency Room situation can be found in Dr. Draper’s MPH thesis available in the Horblitt Health Sciences Library.
79
faced with a lack of access to basic care, were presenting themselves at
the Emergency Room. The department responded to the needs of the
community and for a while even offered a program of follow-up care. The
hospital’s first formal community health needs survey conducted jointly by
the emergency department, primary care, the outpatient department and
the city health department confirmed a need for more access to basic health
care and for better health education. Coincident with these events was the
formation of a joint “Office of Public Health,” a partnership between the
hospital and the city of Danbury.
The iconic solar panels operated from 1978
until 1990 when they were no longer efficient.
Today, with energy again a concern, the
hospital is investigating replacing the solar
panels with photovoltaic panels.
In 1975 the hospital commissioned
the consulting firm of Arthur D. Little,
Inc., to determine the feasibility of
constructing solar energy capability.
That study and later work showed
that the hospital could save $27,000
a year by installing 300 collector
panels on the roof of the tower. The
water-and-anti-freeze-filled panels
weighed 150 pounds each and were
controlled by just four pumps and
three automatic valves. The sunheated fluid passed through heat
exchangers and provided electricity
for heating and air conditioning and
also preheated hot water for the
laundry.
The project did not show a good
financial return until, in 1979, with
oil and gasoline prices breaking
records, the hospital was able to
obtain a grant from the Department
of Energy that paid $436,000 of the
$636,000 estimated costs.
80
Danbury Hospital changed dramatically in the 1970s. The physical
plant with its tower and later its solar panels created the hospital’s
modern look. The hospital enjoyed an astounding 45 percent growth in
admissions, added services, and established itself regionally with expanded
ties to many community agencies. It endured the burdensome demands
of new governmental regulations while still remaining financially sound.
Most of all, the hospital firmly established its vision as a teaching hospital
committed to bringing the most up-to-date knowledge and medical care to the people in its communities.
The hospital as it looked at the end of the 1970s.
2000
BIRTHS
1800
1600
1400
1200
1000
1979
1970
20000
ADMISSIONS
18000
16000
14000
12000
10000
1979
1970
81
Chapter 8
New Complexity New Challenges
1980-1990
82
F
or man and nature the decade of the 1980s stands out for its violent episodes. Mount St. Helens erupted and the
tanker Exxon Valdez spilled millions of gallons of oil on the Alaska
coastline. Assassins claimed the lives of Indira Ghandi and John
Lennon, and failed in attempts to kill the pope and President
Ronald Reagan. Pan Am flight 103 blew up over Scotland and the
Chernobyl nuclear plant collapsed. The U.S. embassy in Beirut was
bombed and the Soviets shot down a Korean airliner. We watched
the TV news and saw our failed attempt to rescue hostages in
Tehran, as well as the massacre of students in Tienanmen Square.
For many Americans, however, the most disturbing image on
television news was the explosion of the space shuttle Challenger.
Americans could find positive news, too. We saw the first woman
join the U.S. Supreme Court and the first American woman orbit
in space. The Berlin Wall came down and the personal computer
opened up new concepts of invention and creativity.
Popular culture endured, of course, and people in Danbury could watch
E.T. at the theater, play Pac-Man, collect Cabbage Patch dolls, and get
frustrated with Rubik’s Cube. Sadness over the closing of the Danbury Fair
gave way to -- sometimes grudging -- acceptance of the new mall.
In 1981 the last 100-lap race at the Danbury Fair Grounds was won by Billy Layda, who is now Director of Safety at Danbury Hospital.
Personal photo.
NEW COMPLEXITY — NEW CHALLENGES, 1980-1990
83
Roscoe the Robot in 1989.
Roscoe (and later Rosie) the robots
were provided by local automation
pioneer Joseph F. Engelberger as
material and food transporters. They
prompted frequent televison news
coverage, visitors, and inquiries from
across the country. The hospital
currently has two Aethon TUG robots
named Care-y and Dottee. They work
24 hours a day and make between
50 and 75 trips to patient care areas
transporting supplies, food trays,
linens, packages, and equipment.
They function on a wireless network
and antennae system navigating
throughout the organization,
negotiating hallways, equipment
and people.
1 A videotaped round table discussion among 13 senior
nurses and supervisors who were involved in the strike
is available in the Horblit Heath Sciences Library’s oral history project.
84
Union Carbide finally moved in, but the Route 7 expansion
remained mostly talk. Our area made the national news when
an FCI inmate held a guard hostage for a time, but that couldn’t
compare to an event in Brookfield that occupied the nightly news
and the front pages of papers from coast to coast.
The Demon Murder had it all: jealousy and violence plus 42 demons and their exorcism from an 11-year-old-boy. Though
it wasn’t needed for the Demon case, DNA was used for the first
time in a criminal conviction.
In medicine, scientists used parallel research to identify the new
and deadly Autoimmune Deficiency Syndrome — AIDS — and
Danbury Hospital treated one of the very first cases diagnosed.
Danbury Hospital —
Time For a New Focus
T
he previous decade of the 1970s saw the hospital grow more
than at any time in its history with the addition of the tower, the
expansion of its programs to better serve the community, and its
development as a full teaching hospital. As the hospital emerged
from the enormous effort devoted to planning and executing that
growth, it found itself confronted by entirely new challenges.
The first challenge arose directly from the intense focus put on
expansion. Managers would later admit that they were singularly
absorbed with growth and innovation, which caused them to
pay less attention to communications and conditions within the
workforce, especially for the nurses. The situation with the nurses
was made worse by a nursing shortage and by high inflation. An
elaborate employee survey had been undertaken in 1979 and the
results and feedback work groups were getting underway when, in
May of 1980, the nurses went on strike. The strike was settled in
June after both sides replaced their negotiators. The underlying
issues most mentioned by those who experienced the strike
and its aftermath revolved around professional recognition, job
satisfaction, and career advancement1.
The hospital addressed the issues first by creating the senior
leadership positions of vice president of human resources and vice
(Top Left Photo) Dr. Matthew
Miller leads an administrative
session with residents.
(Top Right Photo) An
administrative meeting of the
Development Fund includes
Frank Kelly, Shirley LaPine,
Charles Frosch, John Hoffer
and, with back to the camera,
John Creasy.
(Bottom Photo) Hospital
Treasurer Malcolm
Crawford, far right,
meets to discuss clinical
financial administration
with from left,
Dr. Turpin Rose,
Dr. Henry Blansfield,
Dr. Stanley Sapperstein,
Ms. Loretta DoVale R.N.,
Dr. Richmond Hubbard, and
Dr. Joseph Meehan.
president for nursing. Next, these two executives and the administration
addressed the survey results, including establishment of professional
advancement opportunities in both clinical and administrative careers.
Administrative Challenges
The second challenge involved an entirely new level of administrative
demands. If planning and development were marks of the 1970s,
administration defined the 1980s. Driven by their concern about rising
health care costs, state and federal regulators introduced more and
tougher demands on hospitals. The Connecticut Health and Hospitals
Commission (the “Cost Commission”) rejected Danbury Hospital’s 1980
budget. The hospital appealed to the courts and placed the disputed
money in escrow during the suit. More lawsuits followed each year as the
hospital defended its rejected annual budgets.
Another suit arose when the Cost Commission rejected the hospital’s
Certificate of Need for a new three-story building and other major
construction. Danbury Hospital earned a reputation for being the most
litigious hospital in the state. The hospital board defended its legal actions,
explaining that the money budgeted and the construction planned were
necessary to provide high-quality health care to a fast-growing community.
The hospital’s persistence and strategy paid off when all the suits were
favorably settled and the Certificate of Need was approved.
85
Rising health care costs brought other, even more complex administrative
burdens. The single event that would most affect the hospital, its patients
and those who pay the bills was the introduction of a new way that Medicare
would pay hospitals. The new method involved ‘Diagnostic Related Groups,’
or DRGs. Under this method of payment, hospitals would no longer be paid
on the basis of what they spent to provide care to a patient, such as hospital
days, operating room time, supplies or other expenses. The new DRG system
set a fixed price for each episode of patient care based on the diagnosis,
regardless of what hospitals spent to provide that care. If a patient was
diagnosed with pneumonia, he or she was given a DRG of 89 and the hospital
would be paid a fixed fee. If the hospital was able to care for the patient for
less money, it benefited. If the hospital overspent the amount, it lost money.2
The DRG regulations arrived in a 150-page document. Obviously this
monumental change upended the accounting systems at hospitals. Most had
no way to know their costs by patient and diagnosis. Information technology,
though in its infancy in hospitals, took on major importance. In addition to
costs, average daily census, length of stay, and percent of occupancy were now
critical indicators deserving detailed administrative attention. Added cost
pressure came with the Reagan administration’s budget cuts followed by a
flat one-month suspension of Medicare payments. More pressure came when
local area towns, searching for ways to cut rising expenses, made donations to
the hospital a target for reduction.
Employers Speak Out
Although the added administrative
burdens were a challenge, progress and
advances in care continued.
2In fact DRGs were and still are more complex, involving local market costs, severity and many other factors. A parallel structure of codes called ICD - 9 was established for physician services.
3That idealized promise was not fulfilled and HMOs went on to become the often-criticized core of the health insurance structure.
86
Employers in the area became alarmed as they saw health care costs rising
far faster than the general rate of (already high) inflation. News about health
care costs flew onto the pages of The News-Times, not always with a positive
reflection on the hospital. Naturally the hospital would become the focus
of rising health care costs among those paying the bills whether they were
employers, insurers or the residents of the community.
Employers formed a coalition to examine ways to contain costs. The
hospital joined with the employers and also reached out to the community
by forming a broad-based organization called the Community Leadership
Board. Simple cost cutting could not keep up with the rate of inflation that
ran at double digits for several years. Health Maintenance Organizations
(HMOs) were evolving and in their early stages appeared to hold promise that
with proper prevention and other protocols they could help hold down costs.3
The hospital increased its emphasis on health education with the introduction
of Medical Town Meetings and health fairs throughout the community.
More Outpatient Care
A major strategy called for a change
to provide more patient care in an
outpatient setting. The hospital
recognized that patients preferred the
convenience of outpatient care. While
technology allowed for more to be
done in that setting, the hospital had
little dedicated space to do so. The
hospital met the challenge in 1985 by
constructing a new three-story 4 building
with a first floor dedicated to outpatient
care. The plan also called for a large
health education auditorium, classrooms,
and a new parking garage.
The trend to outpatient care proved to be a double-edged sword for the
hospital. Doctors began to do more tests and procedures in their offices.
Their patients found it convenient and the doctors enjoyed the income.
In 1982 the Cost Commission approved the free-standing surgical center
The new outpatient building, later named for Bertram Stroock, under construction
Gerry Robilotti, President and COO looks
on as Frank Kelly, Vice Chairman and
CEO and Robert Morganti, President of
Morganti Construction, sign one of the
many construction contracts of the period.
4In 1997 a fourth story devoted to surgery would be added.
Horblit Health SciencesLibrary.
87
that would compete with the hospital for outpatient surgery while not
bearing many of the hospital’s costs and regulatory burdens.
The hospital managers came to fully recognize the heightened emphasis
on regulation, administration, costs, revenue, and competition and wanted
to insure that they maintained the basic mission of providing quality care
to the community at the center of its actions. Once again challenge meant
change -- this time a complete restructuring of the institution.
The basic idea was to create a holding company as an umbrella over
several activities. The hospital would be better able to focus on its role as
the not-for-profit regional provider of health care while other entities could
work to generate new sources of revenue.
The hospital recognized Harrison
Through this corporate reorganization, the hospital was able to maintain
Horblit, a preeminent book collector, for
his contributions by naming the Health
the flexibility needed for its expansion from a single 450-bed facility to a
Sciences Library in his honor.
regional network of 18 sites in western Connecticut and eastern New York.
At the end of the decade
the hospital chose to honor
two of the most important
ompetition
figures in its history. John
Creasy who had served the
The rush of doctors to the Danbury area that began in the 1970s continued
hospital for 30 years, retired.
and provided the foundation for strong competition not only among
He began his career as the
physicians, but with the hospital. Two large practices, Associated
supervisor in the laboratory
Internists and Primary Care, had grown
“For those of us in healthcare, to more than 25 physicians. Though
and rose quickly to become
the Danbury area in the 1980s
the hospital’s leader. His final
accounts differ, the power of these
was like the Wild West!”
title was president and chief
two groups and other communityDr. Peter Pratt
executive officer of Danbury
based doctors successfully argued
Founder of Primary Care
Health Systems. He presided
against the hospital’s plan to build a
and a developer of the Sand Pit complex
over the hospital’s largest
physician office building across the
expansion, its transformation
street from the hospital. Instead, a new medical complex of buildings was
to an academic teaching
begun by private investors, many of whom were doctors, in the Sand Pit
center, and its most profound
area of Germantown. Included in that complex was the Surgical Center
reorganization, still in place
that would compete for the profitable outpatient surgery business.
today. The hospital honored
Partly in reaction to the rise in competitive power of these new forces
him by naming the new
and partly to insure that it could continue to control its fate and grow
education facility the John C.
as a teaching hospital, Danbury Hospital formed the Danbury Office of
Creasy Auditorium.
Physician Services, a multi-specialty salaried physician practice to “deliver
Bertram Stroock, the most
patient care, provide medical education and conduct research.”
influential philanthropist and
The move underscored the competitive environment. The hospital could
fundraiser in the hospital’s
not become complacent. It was not the only game in town.
C
88
John Creasy
“John was a strong personality who led the hospital
through times of great change. Occasionally his
relationship with some doctors was tested but he was a
careful, effective listener, including with members of the
medical staff. His direct management style was just what
it took during those difficult years. While he could be
tough, he always acted in the best interests of the hospital
and the community.”
Past President, Danbury Hospital Medical Staff
“John was the first administrative leader of the transition
to full teaching hospital. He had the vision of the hospital
as a regional academic center providing a complete range
of specialty and sub-specialty care. That kind of transition
was both complex and challenging. Many points of view,
some contrary, competed for attention. John didn’t
pretend to know all the answers. He regularly sought
advice from staff, board members, doctors, business
leaders and hospital experts. Of course, in the end he
made the tough decisions. The vision and quality of those
decisions greatly shaped the Danbury Hospital of today.”
Gerry Robilotti,
Former Danbury Hospital President
The hospital named its new education center and auditorium in
honor of John Creasy.
“I’m particularly proud of the progress we have made with
the hospital’s education programs. It is a complex process
with many trials and challenges to work through. It has led
to the designation of Danbury Hospital by New York Medical
School as a university teaching hospital, which represents a
major step forward for what was once a community hospital.
Patients can be sure that the care they receive here is the
most up-to-date and meets the highest standards of care.”
John Creasy reflecting on his tenure at Danbury Hospital.
“John Creasy was a man of genuine integrity. While he
held strong opinions of his own, he always engaged others to develop a course of action he deemed was right. With his
strength of character, once he felt he had that right course of action he would lead the fight for it. It didn’t matter whether
it was an insurance company contract or a decision by regulators to deny us a piece of needed equipment, if John
thought we were right he fought it all the way into the courts if necessary. The community can be thankful that John and
his team won most of those fights.”
John Hoffer,
Former President, Danbury Hospital Development Fund
“John Creasy was committed to the principle of excellence through education and clinical leadership. He drew
his ideal model for delivering excellent medical care from academic centers with an aligned physician faculty. He
pursued the concept of an integrated health care system long before the concept was popular, always putting the
patient’s interests first.
John understood the vital role of growth as the lifeblood of an organization and led the development of the hospital and
its medical staff during one of its most significant periods of growth. I was privileged to learn the principles of leadership
through John’s mentorship and his actions.”
Frank Kelly
President and CEO, Danbury Hospital
89
Reorganization - from the 1989 Annual Report
The hospital added resources to its service
area during the 1980s.
Horblit Health Sciences Library
Cardiac Surgery
A Long Journey Begins
It was during this period that the
hospital set an ambitious goal that
would take 20 years of hard work
and strong community support to
reach: providing cardiac surgery for
the people who live in our region.
The hospital had rapidly established
itself as a regional cardiac center
offering complete cardiac care
including the very early use of the
clot busting drug tPA. It lacked
only angioplasty and open heart
surgery. Strong clinical, statistical,
and ethical cases for these services
were made and pleaded to the
regulators twice during the 1980s,
but to no avail. The desire to
provide this state-of-the-art care
stayed strong and the hospital and
its communities finally prevailed,
but not until the next millennium.
90
Many Locations, One Standard of Care
A reorganization of the Hospital’s corporate structure has resulted in the
creation of a parent company, the Danbury Health Systems, Inc., and three
new affiliates, in addition to the Hospital and its Development Fund. The
purpose was to support the Hospital in its mission of providing excellent
health care to all, regardless of ability to pay. The affiliates are:
Danbury Hospital, a regional health care center serving a population of
more than 300,000 with comprehensive services in surgery, psychiatry,
cardiology, nuclear medicine, obstetrics and gynecology, pediatrics, oncology,
radiology, infectious disease, dentistry, renal dialysis, substance abuse,
intensive care, the neurosciences, emergency care and physical medicine
and rehabilitation.
The Hospital’s state-of-the-art technology includes:
• Magnetic Resonance Imaging
• A Special Procedures Room for Angiography and Angioplasty
• Laser Surgical Capabilities
• A Linear Accelerator
• A level II Trauma center
• A Neonatal Intensive Care Unit
• Nuclear Cardiology Imaging
• A Cardiac Catheterization Laboratory
The Danbury Hospital Development Fund, a non-profit organization with
a stated purpose of raising funds for the acquisition of new equipment,
construction of new facilities or renovation of existing facilities, and to support
education and research.
Danbury Health Care Affiliates, Inc., a non-profit subsidiary charged with
designing health-delivery systems for the community’s growing needs. It
includes Corporate Health Care, to help companies control health-care costs
and joint ventures such as WORKLAB, a laboratory for the assessment of jobrelated injury.
Business Systems, Inc., a for-profit subsidiary to manage the Danbury
Pharmacy, a retail pharmacy serving the public, and the acquisition of real
estate and other ventures to provide a broader financial base for the Hospital.
Danbury Office of Physician Services, Inc., employs the multi-specialty,
salaried physician group that serves the Hospital and its affiliates. The
physicians in this group deliver patient care, provide medical education and
conduct research.
history died in 1985. His efforts helped raise millions of dollars. It’s
unlikely that the hospital would have been able to sustain its rapid growth without the energy and influence he brought to bear. To honor him, the newly completed outpatient tower was named simply the Stroock Building.
The impact of Medicare and Medicaid and the price freeze of the
1970s had pushed the hospital into financial losses. Led by the new
CEO, Frank Kelly, the hospital was once again in the black, even after
deducting $23 million of contractual allowances to Medicare and others
and after providing $17 million in charity care. A snapshot of the hospital
at the time would have shown 450 beds, 20 locations in Danbury and
surrounding towns, and a new organization structure that would prove
robust enough to last to the present day.
Bertram Stroock.
In 1987 Danbury Hospital began a multi-year Visiting Fellowship exchange program with
the People’s Republic of China.
3000
BIRTHS
20000
2750
ADMISSIONS
19000
2500
18000
2250
17000
2000
1500
After 11 years serving in a variety of
positions at Danbury Hospital, Frank
Kelly was selected CEO.
16000
1750
1980
1989
15000
1980
1989
91
Chapter 9
“. . . in Partnership
with Those We Serve”
1990-2000
“The owner of a family business today has to be
extremely well-informed on such things as health
insurance and workers’ compensation. We want to
provide security for our employees, but the entire
company will suffer if we are not vigilant against
unnecessary expenses.”
The Management of Marcus Dairy.
92
T
he final decade of the 20th century did not go out quietly. On the world scene the USSR dissolved and the Cold War
was over. East and West Germany reunited and a truce was reached
in Northern Ireland. Here in the U.S., we endured a presidential
impeachment and the O.J. Simpson trial. Johnny Carson retired,
Seinfeld debuted and a host of new Internet companies were making
their founders and investors multi-millionaires.
In Eastern Connecticut two casinos, Foxwoods and the Mohegan Sun,
made millions for their owners while closer to home, our area saw a
14 percent population increase attract three super stores: Stew Leonard’s,
Costco, and Wal-Mart. The local employment sector underwent change
as the big employers reorganized. Danbury Hospital was now the area’s
largest employer.
Health Costs Front and Center
B
y 1990 almost everyone had become aware of skyrocketing health care costs. Employers who bore
much of the insurance burden, including some in our area, evolved from being concerned to being angry.
The expected reduction in costs that were supposed to come from the shift to more outpatient care and
less inpatient care never materialized. Early attempts at managing health care costs were sometimes
confrontational and often clumsy. Threats by employers and insurers to “steer” patients to lower-cost
Local businesses were feeling the pressure of rising health care costs.
“. . . IN PARTNERSHIP WITH THOSE WE SERVE”, 1990-2000
93
hospitals and doctors were met by counter-threats and actions as some
hospitals and doctors refused to sign managed care contracts, which
resulted in patients having to change where they went for care.
Government greatly influenced the attempts to manage health care costs.
In 1993 the Clinton administration introduced its plan for health care
reform. In its quest to improve quality, access and cost the administration
proposed a complex system of regional and local units to foster what it
called “managed competition.” A chart of the proposed plan was leaked
to the press and reaction ran from confused to frightened. The plan was
abandoned, but it set the national context for the discussion about health
care costs and managed care.
The government activity that most influenced managed care continued
to be Medicare. Medicare paid hospitals and doctors much less than
The hospital honored long-time official greeter
and guide Jim Shaw by dedicating the main
insurance companies paid them for the same procedures. Insurance
hospital entrance drive in his name.
companies argued that if those lower fees were acceptable from Medicare,
the same fees or something close should be acceptable from them. The
insurance companies’ argument was supported by employers and,
eventually, the lower Medicare rates became a
shorthand device around which all fees were set.
Key Provisions of the
For a short time insurers, employers, and providers
1993 Clinton Health Security Act
experimented with one of the ideas in the 1993
Clinton plan. Called “capitation,” the plan called for
Universal coverage and comprehensive benefits
an organization of providers, usually a hospital and
a medical staff, that would agree to provide care to
Mandate that all employers pay 80% of the average
a group of people for an annual fixed fee per person
health insurance premium for their workers, with
from an insurer. The idea was that the providers
caps on total employer costs and subsidies for small
would have an incentive to keep people healthy and
business
thereby be able to keep for themselves money not
actually spent on care. The plans generally fell off
Cost control through competition among private
due to concerns about withholding care to keep
health plans and federally determined caps on
the money and because calculating proper fees and
insurance-premium growth
services for a population over any period of time
proved not to be a science.
Establishment of regional purchasing pools (health
The experiment did lead to the formation of
alliances) through which people would enroll in
an organization between Danbury Hospital and
insurance plans
members of its medical staff. The physician hospital
organization (PHO) did not operate under capitation
Financing through employer mandate, savings from
but under a contractual payment schedule.
cuts in projected Medicare and Medicaid spending,
and increase in federal tobacco taxes
94
1990-1999 Emergency Statistics
ADMISSIONS
60000
20000
EMERGENCY ADMISSIONS
58000
19000
56000
18000
54000
52000
17000
50000
16000
48000
15000
46000
1990
1999
1999
1990
For the first time in its history the hospital saw several years of declines in admissions.
Even emergency visits dropped off.
From a 1992 annual report.
A Downward Change
in the Numbers
T
he new managed care programs by insurers and employers were
generally blamed for a decline in activity at the hospital. As outpatient
activity rose, the decade’s numbers for births, Emergency Room visits, and
hospital discharges all fell for the first time in history. Certain inpatient
units were closed or converted to other uses. Because they were no longer
assured of uninterrupted growth, all hospitals began to examine their costs.
A sharp focus on health care costs at Danbury Hospital brought a
system-wide awareness to the fact that without an adequate margin of
revenue above costs, the hospital could not carry out its mission. More
than 20 multi-disciplinary teams using modern techniques and supported
by outside consultants wrung out millions of dollars in cost savings and
prompted substantial organization redesign.
Partnerships
The hospital by itself could not address all the problems and
opportunities related to providing quality access and cost. As it had
throughout its history, the hospital shared the challenges with its medical
staff and with the community. Early in the decade, partnerships
developed between the hospital and employers in the area. An outgrowth
of the search for lower costs, the partnerships started by creating a
highly functional way to manage workers’ compensation cases based on
case management and comprehensive rehabilitation. Other employer
The Blue Star Tattoo
For a short time in the 1990s
Danbury Hospital became a
central focus of the Blue Star
Tattoo legend. The legend
stated that a temporary lick-andstick tattoo soaked in LSD and
made in the form of a blue star
was being distributed to children
in the area in order to get them
“addicted to LSD.” An Internet
mention of Danbury Hospital
caused a flood of inquiries and
press calls from around the
country. No actual cases of LSD
distribution to children in this
manner were ever documented.
The legend has resurfaced
several times.
95
Marie Roberto, Ph. D., and George
Terranova, M.D.,chairman of the
Emergency Department, attending a
Healthy 2000 work group.
partnerships included on-site wellness programs along with pre-and postemployment physicals. More than 50 employers participated in one way or
another, including as members of the Danbury Business Forum.
While the hospital had at times enjoyed partnerships with a broad
array of public groups, agencies and municipalities, the needs now
seemed to require both broader and more formal relationships. Aware
that any partnership required a firm foundation, the hospital launched a
comprehensive community health survey to determine the area’s needs.
The cooperation of the community — among both groups and individuals
— was essential for success. Thirty-two focus groups met over six months
and produced a summary of the leading health concerns.
The hospital incorporated the results1 into a series of collaborative work
plans based on the federal “Healthy 2000” model.
Many of the hospital’s actions for the 1990s were based on the needs
uncovered in that survey. Access to care had been mentioned clearly and
the hospital responded by stepping up its expansion in neighboring towns
like New Milford and Ridgefield. In Southbury, Danbury Hospital
collaborated with Waterbury Hospital to establish a new and very
welcomed medical center. In 1999, to serve patients’ needs, the hospital
implemented a popular free van transportation service between Southbury
and Danbury facilities.
Access
Two courtesy vans transport more than
1000 patients a year. Pictured are
Solomon Gross (wheelchair) and Paul
Gianni (standing) who both live in
Heritage Village. The driver standing
is Ron Auriana.
1Access to health care and its costs were high on the list, but the specifics most often mentioned were smoking, substance abuse, problems of youth, and care of the elderly. Domestic violence, depression and suicide were also often mentioned.
96
A special study based on federal criteria
showed that certain areas of Danbury
were particularly in need of attention to
access of quality care. In response, the
board of directors created a community
health center precisely in the area of need.
Named for a generous donor, The Seifert
and Ford Community Health Center
brought comprehensive medical and dental
care to children, adults and the elderly
along with the community health program
Dr. Tom Draper saying ‘hello’ to a patient
to Main Street. The Community Health
in the Community Health Center.
Center and the hospital’s collaboration
with the Hanahoe Memorial Children’s
Clinic and the AmeriCares free clinic produced a medical safety net for
the under-served. The hospital added another Main Street address when it
opened the region’s most modern physical rehabilitation center.
The development of a crisis intervention program, a methadone clinic,
and dozens of free screenings for conditions ranging from skin cancer to
prostate disease were organized as ways to reach out to the community and
address needs. A diabetes management program combined care, education
and outreach. Programs for parents were expanded.
New partnerships developed around communications and outreach. The
hospital’s Horblit Health Sciences Library established Consumer Health
Information centers in community libraries. Research Day, now a regular
event to showcase the hospital’s broad academic and research projects,
attracted well-known experts as speakers.
To address the communications needs of the growing Hispanic
community the hospital created a new coordinator position and a wellmaintained list of translators. A new Pastoral Care Committee connected
the hospital with dozens of local religious leaders.
Dr. Nilo Herrera escorts Nobel laureate
Dr. Rosalyn Yalow during the hospital’s
Research Day in 1990. Dr. Yalow
delivered the keynote address on aspects
of radiation exposure.
Private photo.
The hospital helped form a regional paramedic program by providing
paramedic services and training such as this accident drill.
The staff at the opening of the Main Street Rehabilitation Center.
Private photo.
The Seifert and Ford Community
Health Center
97
Pastoral Care
The Rev. John Kjoller, Rev. Paul Beavers,
Rabbi Jon Hadden, and Fr. Gilbert
Wdzieczny at the dedication of the
new chapel.
Horblit Health Sciences Library .
A recent picture of the WOW van and
staff. From left to right: Jeanne Steinmetz,
Dr. Humberto Bauto, Larry Durkin,
Debbie Fantel, Kathryn Kinasewitz
and Danielle Mauborgne.
Clergy have been visiting patients at Danbury Hospital since it
opened in 1885. Over the years pastoral care has become an integral
part of the hospital’s function. In 1983, led by Sam Diebler and Ann
Leiss, the hospital and clergy from the community met together and
created a Pastoral Care Committee. The committee worked to define
needs and devise ways to provide pastoral and spiritual guidance for
patients. Clergy and other members volunteered to make regular
visits to patient floors. Some members took turns carrying a pager so
they could be reached when needed.
In addition to serving the everyday needs of patients, the committee set
two long-range goals. The first was to secure space to be able to furnish as
a chapel. The second was to have the hospital engage a full-time chaplain.
Both goals were met in 1995 when the hospital engaged the Rev. Paul
Beavers as the first director of Pastoral Care and, with a large donation
from Union Savings Bank, dedicated the Interfaith Chapel located just off the Main Lobby in the Tower building.
The Pastoral Care Department continues to work closely with
community clergy regarding visitations, services and other patient needs. Pastoral care is available around the clock, by phone from a patient’s bedside.
The Pastoral Care Department offers selected interfaith,
nondenominational programs on the hospital’s closed-circuit television.
It also provides education for community clergy and lay leaders regarding
caring ministries. In addition, the department oversees the Parish Nurse
program, instituted in 1996 to offer orientation, continuing education and
support to congregations who choose a nurse to implement
this preventive health ministry plan on site in their parish.
Affiliation partnerships were formalized with the
Danbury Visiting Nurse Association and Regional Hospice. The hospital achieved substantial success and
recognition with its programs in pediatric asthma and
immunization, both of which involved community
partnerships and outreach.
The WOW Van
One very visible collaboration among the hospital, the
Development Fund, the City of Danbury and the Danbury
Visiting Nurse Association was a new mobile outreach
program, “Wellness on Wheels,” set up in a specially
98
equipped van nicknamed the “WOW” van. Wellness on Wheels provides
a unique mobile health program for families with limited access to medical
care. With the exception of some adult immunizations and TB testing,
most services provided on the WOW van are free of charge. The WOW
van provides physicals, sick visits, immunizations, well child visits, TB
testing and referrals and screenings such as blood pressure, hemoglobin,
and lead testing.
Danbury Hospital’s Auxiliary and Volunteer Services
The earliest meeting minutes and annual reports of Danbury Hospital
include expansive thanks and praise for the work of the women who were
volunteers and auxiliary supporters. Descriptions of their work make it
clear that its members’ efforts were not simply good charity works but were
vital to the hospital’s mission of providing care. Their contributions were
so important that its proceedings were, for many years, included in the
hospital’s annual report.
Mrs. Rita Thal in a recent photo. Mrs. Thal
began volunteering at Danbury Hospital in
1959. During the next half century she was
president of the auxiliary and served as a
hospital board member for more than 10 years.
She continues to volunteer in the coffee shop.
Dean Tozzoli photo.
This mention is from the 1923 annual report.
“To the band of loyal earnest women who compose the Ladies’ Auxiliary,
the Hospital and the public it serves are especially indebted for the unusual
effort made this year to help us in our work. Elsewhere in this annual report
will be found a detailed statement of their many activities which show how
deeply indebted we are to them. Without this spirit of co-operation and
encouragement, I personally feel that I could not continue to give the time and
carry the responsibility required in this work but, with the assured continuance
of this kindly interest by all, the future of Danbury Hospital is bound to be one
of progress and helpfulness to the community.”
Charles A. Mallory, President
Formally organized in 1908 by Mrs. Howard Ives, the 30 women
founders were mostly the wives of community leaders and doctors. The
role of the auxiliary was certainly shaped in part by its membership. Their
minutes reflect very formal meeting procedures and an ability to command
action from others, such as meeting space and donations, and they had the
prestige to attract members. As membership grew, the auxiliary became
an even more important part of the hospital and the members were in fact
its first permanently organized fundraisers. Members opened and operated
coffee shops and gift shops.
In addition to raising funds and securing goods and services, members
of the auxiliary began to volunteer their time. At first the tasks were
99
Children touring the Department of Radiology on Children’s Day.
Horblit Health Sciences Library .
Children’s Day
Begun in 1991, the hospital’s “Children’s Day”
serves two community-service goals. The first
recognizes that by bringing children into the
hospital when they weren’t sick or injured —
showing them around, letting them meet staff, and
touring the “big building on the hill” — would help
alleviate their fears when they did need to visit for
treatment.
The second goal of Children’s Day supports the
hospital’s mission of improving the health of the
community in partnership with those it serves.
It promotes physical activity, good nutrition,
safety, and general wellness to children in a nonthreatening way by creating a free, entertaining
day of “hands-on” educational activities and
entertainment. Many local businesses and
organizations participate as partners.
The event was successful from the start and
grew from 650 attendees in 1991 to more than 3,500 children and their families in 2008.
100
uncomplicated ones such as staffing the information
desk or rolling bandages, but with the advent of
World War II and the acute shortages of all kinds of
labor, auxiliary members began fulfilling many roles
in the emergency room, on the nursing floors and
even in surgical services.
At some point shortly after the war, volunteering
hours of time to work at the hospital evolved to a
separate activity with different, though sometimes
overlapping membership, and became distinct from the fundraising projects of the auxiliary. Women
volunteers were joined by men and students.
At its peak the auxiliary claimed 600-plus
members. Its fundraising in the 1990s involved
completed pledges of nearly $1 million and provided
support to the Emergency Department, Ambulatory
Surgery, and Main Street Physical Rehabilitation.
However, in 1998, after 90 years of service
to Danbury Hospital and to patients in our
communities, the auxiliary was disbanded.
Membership had been declining and most
involved believed that times had changed and
the traditional auxiliary member now had
many options in life to pursue. The fundraising
activities of the auxiliary were taken over by the
Development Fund, which by now had become a
sophisticated operation, and the hourly volunteers
were absorbed into Volunteer Services.
Volunteer Services has grown to encompass
more than 250 volunteers serving in key areas of
the hospital, as well as in many of the hospital’s
off-site locations. Volunteer Services has enjoyed
continuous growth. In 2008 volunteers provided
30,000 hours of important work that both directly
and indirectly benefited patients. The people
who volunteer do so because they care about the
hospital and its mission, and so they also represent
a corps of good will ambassadors into the community.
The hospital used these many partnerships to
Call-a-Nurse
One outreach program caught the public’s fancy in a big way.
Call-a-Nurse offered the public telephone access to a registered nurse
who provided medical information and guidance on obtaining care.
The program combined approved computerized information with the
nurses’ ability to counsel callers and make appropriate referrals. The
nurses were chosen for both knowledge and skill. One nurse spoke
three languages. Calls rose to the thousands per month and, with the
advent of the Internet, the program was transformed into an important
cornerstone of the hospital’s then-new website, www.danhosp.org.
The beam-signing ceremony for the Duracell Ambulatory Surgery Center.
understand and meet community needs. Other partnerships proved
essential to keeping the hospital at the forefront of medical technology
and patient care. Cardiology services were supported by a family
donation that created the Marcus Cardiac Rehabilitation Center. The
growth in outpatient surgery, along with new laparoscopic and other
techniques, demanded more in-depth and comprehensive services. The
Duracell Corporation donated the funds basic to the construction of a
new modern outpatient surgery center that bears its name.
The popular
Call-a-Nurse
program was
transformed
into part of
the hospital’s
website.
Danbury Hospital had been an
early leader in outpatient or
ambulatory surgery. As more and
more procedures lent themselves
to this form of surgery the hospital
responded by expanding into larger
but older sections of the hospital.
Patient demand and convenience
(as well as competiton) required
change. The hospital chose to
build a new center and to do so as
a connected but separate part of
the campus. Using focus groups,
the hospital’s administrators,
archetects and engineers sought
input from patients and from staff
about the design.
The result was The Duracell
Ambulatory Surgical Center
offering patients their own parking
and entrance. The new facility
integrated the patient experience
from entry through surgery,
recovery and discharge. The
hospital was proud to provide
patients a state-of-the-art facility
that matched its state-of-the-art
surgical care.
101
Small courtyard infusion area in the Praxair Cancer Center. The Praxair Center’s linear accelerator.
Complementary
Alternative Medicine
Early in this period the hospital
formalized its program for
complementary alternative
medicine. The practice works
to join body, mind and spirit with
a holistic, integrated approach
to total health care. Staff
provides information to patients
about specialized treatment
with programs designed to
complement and enhance
traditional medicine, rather
than replace it. On-site holistic
services include therapeutic
touch, reiki, and instruction on
relaxation techniques. Staff
also provides referrals for other
complementary treatments.
102
For Cancer A New Model of Care
C
ancer care in the community had been identified as good but
fragmented while the complex nature of the disease requires a coordinated,
multidisciplinary system of care. The need to aggregate such a
multidisciplinary system was identified and a donor partner was found
in the Praxair Corporation. In the Praxair Cancer Center the hospital,
several medical practices, and support services such as radiology and
complementary/alternative medicine were brought together. The creation
of the center represented the model for the hospital’s new concept of
providing comprehensive outpatient services focused on a discrete group of
patients, and doing so in an environment designed specifically to support
healing for those patients.
Other advances required careful allocation of resources. The Emergency
Department, undersized and preparing to be designated a Level II trauma
center, underwent a complete renovation. Investments were made in a sleep
disorders center and an upgraded Level II neonatal intensive care unit. A
major problem with access to the hospital stemmed from a long-recognized
lack of patient parking and was addressed with a new 700-space parking
garage.
The period also saw the early development of practice guidelines that
defined generally approved ways to care for specific conditions. The term
practice guidelines would evolve to include best practices and evidence-based
practices over the next decade.
New In-Hospital Programs
Hospitalists
An important
initiative to
improve quality
and efficiency
involved
Danbury
Hospital’s early
adoption of the
“hospitalist”
program.
Hospitalists
are doctors
who work
full time in
Dean Tozzoli photo
the hospital
caring for patients, a significant change from the
practice of physicians leaving their offices to visit
the hospital for short periods of time. Their expertise
with complexities of inpatient care has been shown
to improve patient safety. The hospitalists’ ready and
continuous availability to patients and their thorough
familiarity with hospital functions provides an added
model of patient care.
Intensivists
The intensivists program was implemented a few
years later. Critical care medicine had become
increasingly complex and costly. To improve
patient care and safety, this program placed the
management or co-management of all patients in
the Intensive Care Units (ICUs) in the hands of a
physician specifically trained in Intensivist (Critical
Care) Medicine. The intensivist in charge, working
with referring physicians, surgeons and primary
care physicians, directly oversees and manages all
admissions to and discharges from the ICUs, and care
during the ICU stay.
Accountability
A
s Danbury Hospital grew in both size and
importance to the region, its board and management
recognized the responsibility to account to the
community for the performance
of its mission. The first step was
symbolic but reflected a significant
reality. The mission of the hospital
was modified with an added phrase
and now became:
“The mission of Danbury Hospital is to advance the health and well
being of people in the community in partnership with those we serve.”
“Partners in Health,” a followon to the Healthy 2000 work, and
“Partnerships in Time,” were themes
used to emphasize the accountable
nature of the relationship.
Accountability relies on
measurement. At the time, the
most recognized measure available
was accreditation by the Joint
Commission on Accreditation
of Health Care Organizations,
or JCAHO. While important, JCAHO and other
certifications offered mostly periodic technical and
administrative measures, not the ongoing measures of
progress toward quality, access and cost.
Inside the hospital, the planning process was revised
and generated specific objectives2 that would be
measured and would affect compensation. To satisfy
its responsibility to account to the public, Danbury
Hospital became the first hospital in Connecticut to
publish a “Quality and Performance Report Card” to
the community. The report card provided unaltered
2 The objectives embraced quality, cost, growth, patient satisfaction, workforce skills, and community stewardship.
103
data on health outcomes, readmission rates, disease complication rates and
other elements to permit the public to assess the hospital’s performance.
To be fully accountable, leadership of the hospital developed an
additional measurement method. The method, called “Community
Benefit,” recognized the hospital’s responsibility as a not-for-profit
organization and its role as the steward of the resources entrusted to it.
Medical Education - A Special Community Benefit
All doctors and most other health care professionals must take part in a
continuous regimen of education throughout their careers. In its role as a
teaching hospital and as a member of the Council on Teaching Hospitals,
What is “Community Benefit”. . .
And What Does It Mean to You?
3
M
uch of what we do at Danbury Health Systems is mission-driven, not
profit-driven. We don’t report to stockholders. Instead, we are accountable
to the people in our communities, and our mission to keep them healthy.
This is a key difference between for-profit and not-for-profit hospitals. As
a not-for-profit institution, Danbury Health Systems holds a tax-exempt
status ... and with that comes responsibility. Specifically, DHS is legally
and morally obligated to reinvest “surplus” monies (profits) in facilities,
enhanced services and charity care to maintain and improve the health of
people in the community. This concept is called “Community Benefit.”
In fiscal year 1997, the total value of DHS Community Benefit activities
exceeded $14 million4.
Community Benefits
Some examples of the 1997 community benefits provided by DHS included:
Adolescent Depression Screening
Adult Health Center
Allied Health Programs
Ambulance Services
Babysitting Course
Breastfeeding Support
Children with Special
Needs Center
Community Center for Behavioral Health
104
Consumer Health Information Centers (in area libraries)
Continuing Medical Education
CPR Courses
Crisis Intervention
Disaster Services
EMT Training
Free Flu Clinic
Geriatric Health Center (Danbury)
Health Fairs
Health Screenings (for high cholesterol & prostate, breast and skin cancers)
Hispanic Services
HIV Screenings
Methadone Maintenance Program
Nursing Student Education
Paramedic Training
Parenting Skills Workshops
Pediatric Health Center
Pharmacy: Deliveries to Homebound
Physician Assistant Training
Police Department Education
Responsive Services Center
School-Based Health Center Support (Danbury High School)
Sexually Transmitted
Disease Clinic
Southbury Transportation Service
Speakers’ Bureau
Support Groups
Trauma Center
Tuberculosis Clinic
Tumor Registry
Wellness on Wheels (WOW TM )
Women’s Health Center
Workshops for Teachers and School Administrators
3 From the 1997 annual report.
4 In 2008 Community benefit amounted to $60 million.
Danbury Hospital every year provides more than 700
accredited continuing medical education programs.
Continuing Medical Education, CME, refers to
programs that physicians take to satisfy their annual
requirements. Each program must be accredited by
the Connecticut State Medical Society which sets welldefined design standards. Programs offered must be in
response to an identified need in the community and
data must be provided to demonstrate that the program
actually meets those needs. The State Medical Society
reviews all CME programs every four years. Danbury
Hospital received Accreditation with Distinction during
its most recent review.
Continuing Education Units, CEUs, are educational
experiences for other professionals such as nurses.
Nurses and many other health care providers must meet
continuing education requirements in order to maintain
licensing and the certification of their professional
associations. Danbury Hospital offers an array of these
courses and hosts many others.
Graduate Medical Education, GME, refers to the
formal residency and fellowship programs for doctors-intraining. The hospital sponsors and participates in seven
residency programs and one fellowship program.5
Providing Primary Care
The long-standing issue of access to health care has
often focused on the practices of internal medicine, nonspecialty pediatrics and family medicine that together
are often called “primary care.” These practices provide
the foundation for the health care system through their
work with the majority of the population in prevention,
diagnosis, treatment and ongoing management of the
most common conditions. Primary care doctors also
generate the bulk of referrals to specialists.
In the early days of managed care, insurance programs
tried to use primary care doctors as so called “gate
keepers.” Patients could not go to a specialist unless they
had a referral from a primary care doctor. The idea was
Eric Jimenez, M.D., Chief Medical Information Officer and
Chief of Intensive Care Medicine, addressing a recent session
of the Primary Care Round table on HealthLink, the emerging
community-wide health information network.
The Primary Care Roundtable
Medical education has been a powerful force at Danbury Hospital and was institutionalized more than
half a century ago. The hospital and the medical staff
take part in a great number of educational program and
one of them, organized and managed by the medical staff,
provides special benefits to doctors and the community.
In 1994 a group of doctors led by Edward Volpintesta,
M.D., organized the Primary Care Roundtable. Originally
called “Meet the Professor,” the weekly breakfast brings
a specialist or sub-specialist physician to address
the community’s primary care, family and pediatric
practitioners. In this interactive meeting the specialist
presents the latest information in his or her specialty
that is relevant to these primary care doctors and their
practices.
The roundtable not only facilitates a flow of knowledge,
it builds personal relationships between the specialists
and the primary care doctors. The primary care doctors
refine their sense of what care they can provide to
their patients and when referrals to the specialists are
appropriate. They become more comfortable about when
questions to specialists might be helpful.
While the primary care doctors receive important
benefits, patients, too, are beneficiaries. As a result of the
Primary Care Roundtable, the latest medical knowledge is
shared with the large corps of doctors who treat the broad
majority of people in our communities.
5 A complete list of the residency programs is contained in the Appendix.
105
that primary care doctors could limit the use of more
expensive specialists and lower overall costs. In Danbury
as well as elsewhere, the gate keeper function proved to be
clumsy and very unpopular with patients and most of the
referral rules were relaxed if not eliminated.
The focus on primary care and its place in providing
access to quality care and controlling costs continues
today as more uninsured patients overload emergency
departments or avoid care until their conditions become
more serious and expensive to treat. Danbury Hospital’s
medical staff includes more than 140 primary care doctors
practicing in dozens of locations in our communities.
Danbury Hospital at the end
of the 20th century.
Pulmonary Medicine
The Pulmonary Section was formed in 1972 when Dr. Arthur Kotch
arrived as the first board certified pulmonologist. During the 1980s, it
grew to include four pulmonologists, and developed a full spectrum service
of complete clinical care, bronchoscopy, pulmonary function testing,
respiratory therapy and exercise physiology testing. The Pulmonary Section
formed the region’s first non-invasive vascular lab and critical care became
an increasing role — with virtually all admissions to the medical or surgical
ICU requiring their consultation.
Since then the section has continued to expand with more sophisticated
invasive and non-invasive tests and treatments to evaluate and manage
complex pulmonary and critical care conditions.
Sleep Disorders — a Special Focus
A high percentage of people suffer from sleep disorders. The conditions
include sleep apnea, insomnia, narcolepsy, sleep cycle disturbances,
restless legs syndrome and parasomnias such as sleep walking. In 1989
the hospital’s pulmonary section formed the Sleep Disorders Center.
Treatment begins with an evaluation and can include lifestyle adjustments,
medications or special equipment to resolve the problem and restore restful
sleep and daytime alertness.
In some cases patients will undergo a sleep study that involves an
overnight stay in one of the center’s six quiet bedrooms. Patients
are monitored throughout the night and board certified physicians,
psychologists and registered sleep technologists prepare a report containing
a diagnosis and treatment recommendations.
In 1995 the Sleep Disorders Center at Danbury Hospital was the first
106
in the state to be fully accredited by the American Academy of Sleep
Medicine (AASM) to offer full consultation, evaluation and treatment for
people with sleep problems.
The decade of the 1990s closed with Danbury Hospital fully engaged in
a broad network of partnerships and affiliations. The hospital participated
in research and gained access to new drugs and protocols. It gained
substantial recognition through accreditations and other certifying
designations.6
It also became the only hospital in Connecticut to be recognized by U.S.
News and World Report in its annual report that provides a rating for the
country’s medical institutions.
The new decade beginning in 2000 would bring more awards and
recognition, but the last order of business for 1999 involved a once-in-amillennium undertaking — preparing for Y2K.
6 A full list is contained in the Appendix.
The Hospital’s People
A “culture of caring” could sound like a cliché, but in interview after interview and in the hundreds of
files in the archives, the caring
character of the hospital’s
people stands out. Whether
for patients or for each other,
caring happens naturally,
not just from the doctors and
nurses, but from employees
as well. Over the years
employees have organized
A typical care team of employees. From left, Sandi
Jubenville; Jared Feeney, R.N.; 9 Tower Unit
picnics, planned holiday
Coordinator Glenda Davis; Linda Roy, R.N.;
parties, formed sports teams,
and transporter Stephanie McDonald.
published a cookbook and
even held bed races.
Francoise Morin and Sylvia McKean
with the hospital cookbook they
Sometimes the events just
developed.
show off employee spirit,
Private photo.
but most often they support
patient care or provide help for
fellow employees.
A team from the Family Birth Center
competes in the bed races. From left,
standing, Linda Carton, Mary Slater,
Dr. Jose Henriquez, Sandy Werdann.
The “patient” is Sandy McGuire.
Private photo.
The Danbury Hospital sports team has grown from
six members to more than 60 and competes, often
accompanied by family members, in numerous
community and fundraising events.
Private photo.
107
Chapter 10
The New Millennium:
A New Model of Care
2000-Today
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Y2K
M
emory of these recent years requires little refreshing. September 11, 2001, remains a time marker for
everyone. Just as a Balkan war was winding down, Afghanistan
and then Iraq became, until late in the decade, the leitmotif of our
times. If not for these events the years might be remembered more
for the hurricanes and tsunamis or for the loss of another space
shuttle or for Enron, the dot-com bubble or the World Series wins
of the Boston Red Sox.
The deciphering of the human genome will be remembered as ethical,
while scientific debate continues about cloning and stem cell research.
Time will judge the outcome of the three presidential elections, two of
which were historic. We will all be part of working through our present
financial challenges.
Welcoming the New Millennium
D
espite predictions of the world-wide catastrophe that would be caused by turning the calendars
— and anything electronic — to 2000, “Y2K” was pretty much a non-event. Danbury Hospital had
dozens of extra people on hand at midnight, but they were soon sent home. What many thought would
be an important event in the hospital’s history proved to be a small matter in comparison to what would
follow. The hospital responded with orderly competence to the tragedy of 9/11 and later to the national
scares caused by anthrax being sent through the mail. Staff adopted new procedures and assembled the
equipment needed to protect and treat the people of the community.
THE NEW MILLENNIUM: A NEW MODEL OF CARE, 2000 - TODAY
109
The New Model of Care
for the Hospital
I
mportant changes had taken place in the hospital during the 1990s. It
strengthened its community roots by expanding facilities and improving
access throughout the region. It mounted dozens of added outreach
programs for education and prevention, and became more than just its
main campus. It accelerated new and more collaborative programs with
physicians. Together they began to organize more comprehensive care
focused on particular groups of patients, much of it in an outpatient
setting. The 1990s also brought the first real efforts to measure the quality
of care and to understand the patient’s experience.
Inspired by its success, and in part by the advent of the new millennium,
in 2000 the hospital embarked on a strategic plan for growth as ambitious
as any in its history. The hospital’s board and management made a strong
statement to the community by committing $100 million to develop the
hospital into a regional center for specialty and advanced care and to assure
patient access into the future.
Before that commitment could be made, however, the board,
management, and the medical staff needed to establish a vision for the
hospital and its future. The vision built upon the strong progress in the
1990s and embodied these principles in a new model of care:
BIRTHS
2550
2500
2450
2400
2350
2300
2250
2000
2008
ADMISSIONS
21000
20000
19000
18000
17000
16000
2000
110
2008
• Care will be comprehensive and well-coordinated.
• Care will increasingly be organized into centers that will focus on discrete groups of patients.
• The environment, whether inpatient or outpatient, will be designed specifically to support the diagnosis, treatment and healing for those patients.
• Our regional presence will be further expanded to make access as
easy as possible.
• Innovative technology, including information technology, will be used
to improve quality, safety, and the patient experience.
• We will set goals that place us in the top tier of quality on a
national basis.
• We will consult with our patients, employees, and other stakeholders
to insure the validity of our vision.
Management and staff would need to implement this vision while still
managing the large and growing institution the hospital had become.
The constraints imposed by managed care firms in the 1990s were
now overpowered by patients, their health care providers, and sheer
demographics. Volumes for admissions and outpatient services were
again on the rise, driven in part by an aging population and a plethora
of new techniques, services and drugs.
The first step involved selecting which areas of care should become
the focus of attention and investment. Cancer and heart disease were
chosen because they are the leading causes of death. The community
lacked access to certain important specialized surgery in those areas as
well as others such as weight loss, digestive services, and orthopedics.
In some cases, such as for cancer, building on skills would be
the strategy. Cancer care in the community was very good but
uncoordinated. In other cases, such as heart surgery, added skills
and resources would be needed.
Each element of the program required an intricate, multi-layered
project plan. Often, multiple projects were underway. The need for
space usually meant relocating departments, facility remodeling, and
even new construction, with each step timed to not disrupt patient care.
Some desired programs could not function at an advanced level without
new, specialized infrastructure investments in radiology, information
technology, or the laboratory. Projects often depended on coordinating
the recruitment of highly qualified physicians and other staff. The
Medical Arts Center project late in the decade even involved moving a school, the Interfaith Early Learning Center, to an adjacent lot.
Financing these large, overlapping projects meant careful fiscal
management. During the decade the hospital managed its affairs so
that its revenue and its surplus over expenses both nearly doubled. In
keeping with its not-for-profit status, the hospital used this surplus to
help fund its community benefits activities and its ambitious vision.
Help came from donors, too. Praxair Corporation’s donation early
on facilitated the development of the Praxair Cancer Center that
brought all the resources to treat cancer into one central and more easily
coordinated location. The center also integrated alternative medicine,
patient education and a patient concierge service. The corporation’s
second major donation in 2005 supported the creation of the Praxair
Regional Heart and Vascular Center.
Medical Arts Center
The hospital chose to fully incorporate
its new model of health care into its
newest building, much as it did with
the Praxair Center. Over its years of
growth the hospital’s facilities were
often put in the only place where they
would fit, which was not always the
ideal location for the patient. A trip to
the hospital for a test and doctor’s visit
could mean difficult parking and long
walks among the maze of corridors on
several floors. The 60,000-squarefoot-Medical Arts Center located
on the hospital campus brought
many of the hospital services and
medical practices together to serve
patients under one roof, with its own
dedicated parking lot. The center
uses state-of-the art electronics
for registration, appointments, and
medical record-keeping. The result
is more coordinated and focused care
and improved patient convenience.
111
History of Philanthropy at Danbury Hospital
T
“Without the generous spirit of the people and organizations
in our communities we would have no Danbury Hospital.”
he quote is attributed to Bertram Stroock, who is recognized as the
most significant force in the hospital’s philanthropic endeavors, and the
sentiment has proven true throughout the hospital’s history. From its
origins in 1885, when local women made and sold quilts to raise money
and Dr. Adams offered his two cottages up to the Hospital Committee,
until the present day, Danbury Hospital owes a great deal to those who
have donated their money and time.
The “free beds,” long since
discontinued, were an early and
creative form of endowment. A
very active Hospital Auxiliary
raised funds, obtained donations of
goods and services and, especially
during World War II, provided
valuable hours of work. A corps
of volunteers continues to donate
tens of thousands of hours of
time each year and raises funds
through the gift shop and coffee
shop operations. Contributions
and grants by state and local
governments at times have been
vital to the hospital’s operation.
Many of the community
fund drives and money-raising
appeals mentioned elsewhere in
this book were singular events
often focused on a particular
project. Gradually the hospital
managers, the medical staff, and
the community came to recognize
the need to organize the hospital’s
fundraising on a more orderly and
112
sustaining basis. In 1957 it created
the Development Office with a fulltime director. The hospital needed
both expansion and modernization.
The Development Office, however,
would not exist just for the
immediate building program.
The board and administration
recognized that the hospital would
need ongoing annual support. A
special Progress Fund within the
Development Office declared that
money raised through donations
would be earmarked not for
operating the hospital but rather
“to meet the constant demand
of modern medicine for new
equipment and facilities.”
The Progress Fund folded itself
into the Development Office in
1971 and in 1974, in the face of
rapidly escalating federal and
state regulation, the hospital
formed a new, not-for-profit 501
(c)3 organization, creating the
Danbury Hospital Development
Fund as a separate entity. In the
years that followed, the role of the
Development Fund expanded to
include not only capital building
projects, but also equipment
purchases, new programs,
continuing education, medical
research and community outreach.
As the role of the Development
Fund evolved, so did its fundraising
strategies. The fund now uses
events and other ways of giving to
generate philanthropic support for
Danbury Hospital:
Fundraising Events:
The annual Garden Party ran
from 1976 to 1997. It was held at
the home of donors and featured
tennis exhibitions, art auctions and
croquet contests.
The Annual Ball was started by
the Stroocks in 1959 and continues
to be the event of the year. This
long-standing tradition has raised
millions of dollars for the hospital.
The “A Day to Make a
Difference” Auction began in 1994. Now an annual event, it
raises money for the hospital’s
pediatric programs.
The Danbury Hospital Cancer
Golf Tournament began in 1988
and raises funds kept in the
Danbury community to support
cancer programs and services.
Other Ways to Give:
The Development Fund receives
much of its funds through
annual giving campaigns, capital
campaigns, estate planning,
grants, sponsorships and major
gift bequests. Some major gifts
have established endowments that
provide interest income to support
clinical advances, programs and
services at Danbury Hospital for
years to come.
Like most foundations of its
kind, the Development Fund will
honor a very large major gift by
naming a program or services for
the donor, such as The Praxair
Cancer Center, The Duracell
Center for Ambulatory Surgery,
The Seifert and Ford Community
Health Center, the Carmen Lucia
and Peter Buck Chair of Surgery,
the Fred and Irmi Bering Chair in
Laparoscopic Surgery, the Linda
and Stephen R. Cohen Endowed
Chair in Vascular Surgery, the
Harold and Myra Spratt Endowed
Chair in Minimally Invasive
Surgery, and The Carmen Lucia
and Peter Buck Center for Robotic
Surgery.
The Development Fund
recognizes the generosity of
its donors through its “Giving
Societies.”
• The Presidents Club is for donors who give at a certain
level each year.
• The 1885 Society is for those who have included Danbury Hospital in their estate planning.
• The Stroock Society recognizes those donors who have donated a cumulative $1 million or more to the hospital.
as a nationally recognized and
top-ranked hospital. These gifts
allow Danbury Hospital to stay
at the forefront of advances
in medicine and ensure the
continuing availability of the very
best that medicine has to offer to
our patients. Our buildings, our
equipment, our programs, our
research and our outreach into
the community simply could not
happen without what Mr. Stroock
called ‘the generous spirit of the
people and organizations in our
communities.’ “
Catherine Halkett, President,
Danbury Hospital
Development Fund
“Donations play a major role
in establishing Danbury Hospital
113
The battle for cardiac care
In 2004, after four attempts spread over 30 years,
Danbury Hospital won approval to provide fully
comprehensive cardiac care, including openheart surgery and angioplasty, to patients in the
community. The battle had centered primarily on
the question of whether Danbury Hospital would
treat enough cases to achieve and maintain
A special piece of
competence or whether patients would be better
jewelry was designed to
served by traveling an added distance to an
promote the effort to get
expanded cardiac care. existing program. The regulatory argument may
have been framed around a quality issue, but
behind the scenes were pressures on regulators and legislators from
competitor hospitals with existing cardiac programs worried about
losing referrals from the Danbury area.
The hospital and the medical staff always felt they had compelling
data and logic on their side for having cardiac care in the community
but, up until now, had been turned down. The standards for cardiac
care had changed and it was necessary that people in western
Connecticut have the same access to these latest treatments as
people in the rest of the state. A full cardiac care program was an
essential anchor for the hospital to establish itself as a true regional
referral center not only in the eyes of patients, but in the eyes of the
region’s referring physicians.
Certainly times and demographics had changed over the years,
but credit for success this time goes in no
small part to people in the community. More
than 30,000 signatures and letters of support
and the passionate testimony of hundreds
of business leaders, legislators, patients
and family members capped two years of
debate with approval for the program. Just
as they have since 1885, the people in the
community worked to insure that they would
have a first-rate hospital.
114
The hospital proudly announced that the
community would have advanced cardiac care.
Centers of Excellence
B
ased on the concept that the nature of disease requires a coordinated,
multidisciplinary system of care, the hospital established a number of
specialized programs and centers. The creation of the centers reinforced the
hospital’s medical model of providing comprehensive outpatient services
focused on a discrete group of patients and doing so in an environment
designed specifically to support healing for those patients.
• The Duracell Center for Ambulatory Surgery
• Main Street Physical Rehabilitation Center
• The Community Center for Behavioral Health
• Level II trauma center
• The J. Benton Egee, M.D., Emergency Department
• The Seifert and Ford Family Community Health Center
• The Family Birth Center
• The Center for Child and Adolescent Treatment Services
• A Level II Neonatal Intensive Care Unit
• The Sleep Disorders Center
• Primary Stroke Center
• The Endocrine and Diabetes Center of Western Connecticut
• The Center for Digestive Disorders
• The Asthma Management Program
• The Robert J. and Pamela Morganti Center for Wound Care and Hyperbaric Medicine
• The Nelson Gelfman, M.D., Dialysis Center
Three centers were designated centers of excellence1
The Praxair Regional Heart
and Vascular Center
Though open only since 2005, The Praxair Regional
Heart and Vascular Center places in the top 5 percent
nationwide for overall cardiac services.2 The center
has assembled a team of multi-disciplinary specialists skilled in the latest
techniques for preventing, diagnosing and treating heart and vascular
disease. Danbury Hospital is now a regional resource offering advanced
cardiovascular care with superior outcomes. In fact, the Praxair Regional
Heart and Vascular Center rose to Connecticut’s No. 2-rated program in
2008 and achieved the No. 1 ranking in 2009.
1 The latest listing of the hospital’s centers and their awards and other recognition can be found in the Appendix.
2 The designations are those of HealthGrades, an independent health care ratings company.
115
The Center for Weight Loss Surgery
Weight loss surgery, also known as bariatric surgery, requires both
exceptional surgical capability as well as tightly coordinated patient
preparation and follow up. The team at Danbury Hospital’s Center has
performed more that 1,300 procedures with results that have earned
them designation as a “center of excellence” from the American Society of
Bariatric Surgery. The center also earned the top “1A” accreditation from
the American College of Surgeons Bariatric Surgery Network.
The Center for Advanced Orthopedic and Spine Care
Community demographics and more effective, minimally invasive
techniques have combined to produce a record number of people
seeking specialized joint and spine care. In recognition of the demand
and based on its long experience and the skills of its surgeons and
other members of the medical team, the hospital created the Center
for Advanced Orthopedic and Spine Care. In addition to orthopedic
and neurosurgeons, the center includes nurses, anesthesiologists, pain
management specialists, physician assistants, radiologists, chiropractors,
physiatrists, physical therapists and others.
The center ranked among Connecticut’s top five institutions for total
joint replacements in both 2008 and 2009.
A Center of Excellence
for Cancer Care Planned
I
A tumor board at work. Tumor boards
for every type of cancer provide experts
in all specialties to offer consultation on
the best approaches for each individual
patient case.
116
n this decade the hospital responded to growing needs
for specialized surgical and other cancer care treatment
as it structured programs in a variety of minimally
invasive techniques, and sub-specialty expertise such as
hepatobiliary surgery. The present Colon and Rectal
Cancer program provides patients with colorectal surgeons,
gastroenterologists, and oncologists trained in the latest
prevention, detection and treatment techniques and will soon become a cornerstone of a new Center of Excellence
for Cancer Care. The center will employ full multi-disciplinary teams,
featuring dedicated Tumor Boards for each type of cancer, and will expand
research and clinical trials.
Essential Technologies Radiology and Laboratory
F
rom the earliest days of the hospital’s history, radiology and laboratory
services have brought innovative and state-of-the-art practices to
Danbury Hospital and the community. These two most technically
based departments play integral and critical roles in each of the centers of excellence as advancements in imaging and genetics expand their impact on patient care.
The Department of Radiology
Danbury Hospital’s Department of Radiology, staffed by Danbury
Radiological Associates, P.C , and licensed radiology technologists perform
more than 200,000 procedures annually, and provide patients and
physicians with service around the clock. The department serves inpatients,
outpatients, and Danbury Hospital’s Level II Trauma Center emergency
patient visits.
The Department of Radiology provides state of the art examinations
in all major imaging subspecialties including CT scans, diagnostic
imaging, interventional radiology, iodinated contrast injections, MRI,3
mammography (including digital mammography with computer-aided
detection) PET scan, ultrasound, and radiation oncology. In collaboration
with cardiology, a new coronary CT angiography program has been
created to noninvasively assess patients at risk for coronary artery disease.
The department employs technologically advanced digital archiving that
3 The department also provides wide bore MR that reduces feelings of claustrophobia. High field strength (3T) MR imaging has been advanced to perform MR spectroscopy, functional brain imaging and neural tract imaging (tractography).
117
“The scientific extension of
these genetic-based efforts is now
leading to a practice known as
pharmacogenomics which holds
the promise of personalized
medicine. The goal is to offer
patients a precisely targeted drug
at a precisely calibrated dose to
address a specific ailment based
on the genetics of each patient
and each drug.”
Ramon Kranwinkel, M.D.
Chair, Laboratory Medicine
Primary Stroke Center
Stroke is the leading cause
of disability and the thirdleading cause of mortality
among American adults.
Recognizing that care for
stroke demands fast response,
specialized training and tightly
coordinated care, Danbury
Hospital and the section of
neurology created a Primary
Stroke Center. By focusing
on superior stroke-response
practices, research, clinical
trials, teamwork, and improved
outcomes, the hospital built
a multi-disciplinary center to
provide first-rate stroke care
for patients in our communities.
These dedicated resources
and the high level of care
earned the formal designation
of Primary Stroke Center by
both the Joint Commission
and the State of Connecticut
Department of Public Health.
118
eliminates film and permits access to images from any approved location,
including physicians’ offices and homes.
Laboratory Medicine
Danbury Hospital’s laboratory provided leadership for several pioneering
programs over the years, including the hospital’s first residency program,
the region’s first blood bank, and its nationally recognized nuclear medicine
program. It was an early leader in providing satellite locations out in the
community to better serve patients and their physicians.
Today the laboratory works at the forefront of science using molecular
techniques, among others, that examine cells and their components at their
very basic DNA and genetic levels. These new tests enable doctors to more
exactly identify cancer types and conditions such as the drug-resistant staph
infection MRSA. The use of genetic information also assists in adjusting
drug dosages to specific patients, especially useful with blood-thinning
drugs such as coumadin.
Measuring Excellence
D
etermining the quality of health care, let alone assigning the term
“excellence,” has been a long-standing challenge for hospitals, doctors,
insurance and government agencies and for patients and their families.
This decade has seen real progress in measurement.
Data
Information technology boosted the ability to gather, analyze and
display data at the same time that pressure to collect the information grew
from Medicare, insurance companies, JCAHO, and various boards of
accreditation. But data needs to be comparable to be useful. In health care
one of many steps involves “risk adjustment.” For example, in assessing
a hospital’s length of stay for patients, it is important to know whether
one hospital’s patients are sicker than others. Pooling, adjusting and
aggregating data from a variety of sources has proven to be a problem that
technology and time continues to improve.
Standards
While data presented a more-or-less objective challenge, setting standards
or benchmarks required gaining agreement on just what constituted
quality care. Early measures often set standards around the average of
reported data. Later, the data was sorted to seek the best performance
and designated that performance as “best practice.” Additional and more
refined quality measures based on the evidence of better patient outcomes
continue to evolve.
Danbury Hospital — Measuring to insure excellence
Danbury Hospital was first among Connecticut hospitals to develop a
‘report card’ for its quality and cost performance. Over the years, the job
of reporting has shifted to outside, objective entities that include accrediting
agencies, private health data firms, and Medicare. Today patients and their
families can find quality ratings of hospitals and doctors on a variety of websites, including www.hospitalcompare.hhs.gov and www.medicare.gov.
Research - A Strategic
Direction for the Future
D
anbury Hospital’s clinical care is recognized as among the best in the
country. Over 50 years ago, the board of Danbury Hospital made medical
education an institutional priority. As a result, the hospital evolved into an
academic medical center with nearly 100 physicians in training. Medical
students from a variety of medical schools spend portions of their third
and fourth years learning from hospital faculty members. In addition,
the hospital offers educational programs for advanced degrees in nursing,
including a doctorate in nursing practice, as well as training for radiology
and surgical techs and others.
With medicine entering a new era as the human genome unfolds,
the hospital has embarked on a major new initiative devoted to medical
research. The hospital’s commitment to scientific research is a natural next
step in its mission to improve the health of the community. The initiative
will incorporate translational research to bring scientific discoveries from
the laboratory bench to the patient bedside. It will engage in clinical trials of prevention and treatment strategies, as well as epidemiology (the cornerstone of public health research) and health outcomes research.
The research program will involve not only physician scientists but nurses, public health experts, biostatisticians and computer engineers,
among others.
“Measurement of quality performance
constantly improves. Danbury
Hospital and its medical staff now
benchmark themselves against a host of
useful, sound measures of quality and
efficiency, including rigorous patient
satisfaction studies. But the purpose
of doing all this measurement is to
improve patient care and safety. We
focus on improving care by instituting
processes and treatments that result in
measurably better outcomes as shown
by the evidence that a particular
practice of treating patients is the most
effective and efficient. We don’t want
the concept of excellence to become
overused and debased. We can never
be complacent. There is always more
that we can do to achieve excellence in
patient care.”
Dr. Matthew Miller,
Chief Medical Officer
119
Information technology - A Force for Change
I
nformation technology at Danbury Hospital demonstrates both evolution and revolution. In 1971, employing
a strategy of using the technology that was available, the hospital introduced a computer dedicated to
automating laboratory results. It soon added the capability to do its own programming. From the late 1970s
through the 1980s the hospital adopted a strategy that moved from dedicated computers to one that involved
IBM and reliance on a mainframe computer to serve as a platform for information technology. During that time
Danbury Hospital became the first hospital to run health care software on some of IBM’s new equipment and
among the first to use color displays and printing to highlight key results and help classify information. The
information technology department added the capability to computerize orders and to report results to the
nursing units for access by nurses and physicians.
As IBM encountered difficulty in its health care business,4 the hospital moved to a strategy based not
on computers, but around systems. It sought out the best systems for individual applications. The strategy
evolved to implement systems for clusters of departments like laboratory, pharmacy and radiology. During the
1990s the hospital pioneered wireless technology in the Tower Building, permitting better communications and
setting the stage for later developments.
By 2000 laptops were in use at bedside. Soon digital radiology replaced X-ray films and their inefficient,
expensive storage. Hospital systems now allowed doctors to view these digital pictures instantly and from
almost any secure location. In 2001 the move to computerized physician order entry (CPOE) was underway.
CPOE allows doctors to enter their orders directly into the computer rather than writing them out for nurses to
enter. CPOE not only eliminates handwriting errors, the system has many built-in rules that eliminate waste
and help doctors make safer and better choices for patient care. CPOE is now fully implemented, placing
Danbury Hospital among the national leadership in this technology.
While it’s a bright spot, CPOE has been an exception in the healthcare information technology landscape.
Everyone — hospitals, doctors, politicians, employers, insurance companies and patients — now recognize
that information technology must help revolutionize the fragmented health care system.
“Today our strategy addresses recognized needs like electronic medical records and efficient information
exchange of patient data that now involves not only the hospital, but physicians’ offices, pharmacies,
laboratories and others including patients themselves. Our new community-wide initiative called HealthLink
will electronically connect all these players and targets major improvements in efficiencies and reductions of
costs.
However, improving efficiency is only part of the story. HealthLink is fundamentally a medical system with
very complex and integrated rules for patient care and management built into it. No matter where a patient
seeks care — or fails to seek prescribed care — his or her complete record and treatment program will guide
both the caregiver and the patient. The system will track treatments and measure outcomes.
HealthLink will improve both the efficiency of health care and its effectiveness, safety and quality. It will
bring about profound change for patient care in the next decade.”
Peter Courtway
Chief Information Officer
5 The hospital has also constructed a fast growing Lyme Disease patient registry and that data is available to 4 IBM left the health care business in 1989.
researchers.
120
The research strategy, like many hospital initiatives, involves partnerships.
Within the region many companies, educational institutions, and other
healthcare facilities possess research capabilities and infrastructure. Some
foundations, agencies, and individual donors have sincere interests in
scientific advancement and all of them are potential partners. So are
existing research programs such as the National Cancer Institutes’s
biomedical information grid (caBIG), a voluntary information network
that enables researchers to share tools, standards, data, applications and
technologies.
The hospital’s HealthLink project, described earlier in this chapter,
connects all the health care providers and information in the community.
Over time this massive compilation of health data5 will allow researchers to
actually measure progress toward the hospital’s mission of improving the
health of people in the community.
Other programs and services
The Family Birth Center
Danbury Hospital was challenged to adapt to a new medical standard and
cultural shift early in the 20th century when at-home births gave way to
births in hospitals. The hospital quickly created dedicated units and has
continually modernized them as new and better methods of care became
available. Today the hospital is recognized as a regional center for high risk
pregnancies. Supported by obstetricians and pediatricians on the medical
staff, the service, now known as the Family Birth Center, provides 25
private rooms and is recognized as a regional perinatal and neonatal center.
The center provides specialists in high-risk pregnancies and special labor
support with its Doula program that works to enhance childbirth with
added comfort and personal attention from support people who provide
non-clinical assistance to ease pain and encourage women throughout the
labor process.
Because about 10 to 15 percent of newborns come into the world with
complications, the Family Birth center also provides a Level II Neonatal
Intensive Care Unit (NICU) to care for premature babies and those who
are ill at birth. Plans for the future include a new NICU and expansion
of the Family Birth Center to add more private rooms and state-of-the-art
imaging.
“Our ambitious research program
provides important benefits to the
community. It will bring about
local, regional, and even national
collaboration to leverage money and
time. That will allow us to do more
and to produce superior results. Our
progress will draw more allied research
activities to our area attracted by our
available HealthLink and other data,
our projects, and our capabilities.
First-rate research will attract first-rate
people, including scientist physicians,
into our community, and those people
will attract more resources for research.
Most importantly our medical
research will develop faster pathways to
better, safer care for our patients.”
John M. Murphy, M.D.
Executive Vice President
A Special Focus on
Womens’ Health
While women participate in
the mainstream of medical and
surgical care, they do have
special needs in such areas as
breast health, heart disease, urogynecology, osteoporosis, and
pulmonary disease. In addition to
redesigning its Family Birth Center
and NICU facilities, the hospital
is organizing a community-wide
multi-site, multi-specialty program
to address those special needs of
women from child-bearing years
and throughout their lifespan.
5 The hospital has also constructed a fast-growing Lyme Disease patient registry and that data is available to researchers.
121
Dr. Ed James,
Chief of Neonatology.
Pediatrics
Dr. Jack Fong, long-time
Chair of Pediatrics.
Danbury Hospital’s Pediatrics Department
has also achieved excellence on several levels.
The Level II Neonatal Intensive Care Unit
draws from a wide area to treat premature
and other high-risk newborns. During
recertification it was cited for its excellent
outcomes. The Pediatric Pulmonology
Section has been recognized statewide and
in medical publications for its asthma management program. The most
visible and noted accomplishment has been the department’s work, in
partnership with the community, regarding childhood immunizations.
Under the leadership of long-time Chairman Jack J. C. Fong, M.D, our
community boasts the best childhood immunization rates in Connecticut,
which leads the nation.
Dental Services
Danbury Hospital Dental Services began as a small clinic to serve the
needs of Danbury residents in 1956. The service was founded by area
dentists who donated their time and expertise to treat patients in the
community.
Presently, the service resides at the Seifert & Ford Community Health
122
Center on Main Street, providing 10 treatment areas, resident office, staff
conference rooms and lab. The hospital offers dental specialty services
in periodontics, endodontics, oral surgery, pedodontics and operating
room dentistry to the community and special-needs patients. The service
includes three full-time residents, 10 full-time assistants, hygienists and
office staff, and more than 24 general and specialty dental attendings
that accommodate more than 13,000 outpatient visits per year, hospital
consultations, emergency room coverage and OR patients.
Danbury Hospital Behavioral Health Services
Danbury Hospital’s Behavioral Health Services dates back to its earliest
days and provides a comprehensive continuum of care for people with
psychiatric and emotional problems. Psychiatric physician-supervised
treatment programs include crisis intervention, mobile crisis outreach,
inpatient psychiatric care, psychiatric consultations to patients hospitalized
for medical or surgical reasons, intensive outpatient treatment for children,
adolescents and adults, and general child and adult outpatient services.
It actively partners with other institutions in the community to provide
integrative care, including the Greater Danbury Mental Health Authority.
The department designs age-specific programs to relieve emotional and
personal distress for people suffering from psychiatric illness and dual
diagnosis disorders. The staff focuses on helping patients overcome the
patterns of behavior that impede daily living and that are complicated by
psychiatric illness.
Care is provided at
the hospital and at two
out-patient centers, one
of which specializes
in care for children
and adolescents.
These centers offer
services by teams that
include psychiatrists,
social workers,
licensed alcohol and
drug counselors,
licensed professional
counselors, advancedpractice psychiatric
New Pediatric
Sub-specialty Center
Diabetes and obesity are now
recognized as serious diseases
of childhood requiring specialized
attention. But children also have
needs for other specialized care
for asthma, heart disease, cancer
care and other conditions. The
growing need for these subspecialist caregivers to provide
care here in our community
provided the stimulus for the
hospital to form the Center for
Pediatric Sub-specialty care. The
Center opened in 2009, and is the
first in the region to bring these
services together into a single,
child- and family-friendly location.
123
nurses and registered nurses who provide assessment and evaluation, group
and individual therapy, family counseling, and medication management.
Additionally, the department is actively engaged in the education and
training of medical students, psychiatrists-in-training, social workers and
nurse practitioners through affiliations with New York Medical College
and St. Georges University. With the anticipated growth of the hospital,
the department envisions its role expanding to meet the needs of patients
throughout the health care system, as well as collaborating in future
clinical research.
Gerard D. Robilotti
Conference Center Dedicated
O
n April 10, 2008, Gerry Robilotti and more than 100 of his friends,
family and colleagues attended the dedication of the new 2,200-squarefoot facility located just off the main hospital lobby. The center honors
Gerry’s more than 35 years of service to Danbury Hospital. He retired
as executive vice president of the hostpital’s parent organization, having
served as president of the hospital from 1988 to 1994. The center
appropriately adds much-needed capacity for education and training,
which have been his profound interests.
A Focus on the “Patient Experience”
F
or decades the hospital has
used a variety of indicators
to measure and improve its
clinical care. But those mostly
quantitative tools were not
intended to capture a very
important factor — how the
patient measures care. The
hospital developed some
home-grown questionnaires
regarding patient satisfaction
and, while helpful, they were
not sophisticated enough to
124
provide real data to compare
Danbury Hospital to other
hospitals or to develop specific
ways to improve the patient’s
experience.
In the late 1990s, consistent
with leadership’s commitment
to measure all aspects of
its performance and to be
“transparent” to its publics,
the hospital began to compare
its level of patient satisfaction
through a nationally recognized
firm that specialized in surveying
patients from thousands of U.S.
hospitals for detailed information
about their hospital experience.
Initial results showed areas of
good experiences and areas with
opportunity for improvement.
Using this independent
comparative information,
management developed a more
formal program to create a
culture of “service excellence”
based on national best practices.
By 2004, Danbury Hospital
had achieved the stature of a
local community hospital with
Gerry Robilotti cutting the dedication ribbon, flanked by Frank Kelly, John Murphy, M.D., and Martha Robilotti.
a growing regional reputation
that was beginning to be
recognized for achieving national
best practices in clinical care
outcomes. The hospital was
participating in virtually every
national and state performance
comparison initiative for all
aspects of hospital care (clinical
outcomes, patient safety, and
patient satisfaction). Hospital
leadership next established
the expectation that Danbury
Hospital’s performance in
all aspects of care should
achieve national recognition
by 2010 by achieving the top
10th percentile performance
of all U.S. hospitals measured
by recognized independent
authorities. Leadership was
determined to create a quality
and service excellence culture
that would redefine the patient
care experience and serve as
a model for others. This new
patient experience would be
based on superior performance
in patient care quality and service
excellence, prudent use of
information technology, creation
of a healing environment, and
partnering with patients and
their families through principles
of patient-centered care.
Through education and
training, the hospital has ranke
d in the top 10th percentile
national comparison rankings
in recent years in all categories.
The attention to the patient
experience and putting the
needs of patients and their
families first remains the
hospital’s top priority.
125
The Special Role of the Board
T
he history of Danbury Hospital is, at its core, the story of an enduring three-part relationship bound together
in a common mission to provide for the health of people in the region. The roles of the hospital administration
and the medical staff in that partnership are fairly well understood. The role of the board of directors, those
people who represent the community, may be less well known, but is no less important.
In recent times it has been the board, through formal consultation with the hospital’s many stakeholders and
through its own research and studies, that guided the hospital toward its new model of health care. The board
established the hospital’s ambitious goals to place Danbury Hospital in the top 10 percent in national rankings.
The board adopted specific, measurable goals called “vital signs” and established systems for their review and
oversight. In all its work, the board has continued the tradition of representing the people of the community.
126
A Final Snapshot
I
n this decade of complex challenges Danbury Hospital rose into the elite level of national health care
institutions. Numerous independent rankings and agency reviews6 clearly show that the hospital’s programs
and care provide top quality and safety. As an academic medical center, the hospital now provides our own
communities with the broad range of medical education, research, and services found at other large centers.
The evolution of the hospital from two small cottages on Crane Street has not been a random or piecemeal
process. The generations of people who brought the hospital to its present status, who faced challenges and
brought about change, did so because they were driven by the purpose of the mission.
The words of the hospital’s mission have changed very little in 125 years: “To improve the health and well being of people in the community through medical care, education, and research in partnership with those we serve.”
6 The full range of rankings and certifications can be found in the appendix.
127
Postscript
128
Looking Ahead
T
his final chapter uses interviews as a way to look ahead at the
future of Danbury Hospital. The
first section of the chapter presents a
distillation of dozens of interviews with
doctors, nurses, and administrators,
mostly retired, who served during the
past several decades of the hospital’s
history.1 The second section contains
the views of today’s hospital and
Medical Staff leadership.
1 The names of those interviewed are contained in the Acknowledgments.
LOOKING AHEAD 129
From the Interviews
The interviews with these doctors, nurses, and
administrators covered a wide range of topics and,
as mentioned in the Acknowledgments, the many
notes and tapes are available in the Horblitt Health
Sciences Library’s oral history project files. The
interviews did impose one structural device; two
of the many questions were posed exactly the
same to every interviewee. Here are those two
questions and a distillation of the answers to them.
130
1. After your very long association
here, what is it about Danbury
Hospital that you want people
to know?
The answers displayed enormous
pride tinged with a desire to enlighten
people in the community about
Danbury Hospital. Here is what the
interviewees want people to know:
“We provide the community with
Centers of Excellence that rank up
at the top with hospitals anywhere.
Patients don’t need to travel.”
“The quality of medical care here
is second to none. The top quality
ratings the hospital gets from
independent firms come in year
after year.”
“Danbury Hospital conducts
important research and participates
more and more in trials of the latest
drugs and techniques. That’s good
for our patients.”
“There is a certain very strong
culture here. It was here when I
started nursing and it’s still here —
everyone cares and wants to do the
right thing. Danbury Hospital has
a personality of care from top to
bottom; care for each other and
care for patients.”
“We have come from being a fine
community hospital to become a
first-rate academic medical center.
I’m not sure everyone knows how
important that is.”
the hospital will stay at the forefront
of medical care.”
“Sometimes people forget that the
hospital is not-for-profit. It does
so much in the community with
outreach, clinics, free programs,
screenings and prevention. It cares
for people regardless of their ability
to pay. “
“Great opportunities lie ahead to
exploit computer technologies for
better patient care, streamlined
operations and lower costs.”
“These are extremely well-qualified
and talented doctors.”
“The new techniques, equipment,
and medicines are great things,
but they all cost more than what
they replace. That will bring added
pressure.”
These retired interviewees provided
candid and tough comments in
their interviews, but when it came
to this question they all said, one
way or another, “Tell everyone what
a great hospital they have.”
“The way Danbury Hospital
is governed with a mix of
administrators, physicians and
public citizens gives it the best
chance to handle the cost and
access problems ahead.”
2. What do you see as
the challenges for Danbury
Hospital in the future?
The answers to this question provide a
sober consideration of what Danbury
Hospital and the health care system in
general are facing. The interviewees
were concerned but optimistic.
“Health care in our community
will become better coordinated and
patient-focused. Danbury Hospital
will play the leading role.”
“Danbury Hospital’s academic level
of teaching and research is good
insurance for the community that
“Much of the future depends on
political decisions. We have to face
the challenge of the uninsured and
the high cost of end-of-life care.
We’re part of a national challenge
because of the huge costs of
Medicare and Medicaid.”
“In some cases we face ethical
challenges; should we spend
millions on equipment and
programs that improve the care
for a relatively few patients, or
should we use those resources more
broadly to improve the health of
the community? We don’t have
unlimited resources.”
LOOKING AHEAD 131
Left to right: John Murphy M.D., Executive Vice President; Frank Kelly, CEO and President; John Martocci, Chairman of the Board;
Mathew Miller, M.D., Chief Medical officer.
From Today’s Hospital and
Medical Staff Leadership
We posed the final questions about the future to
today’s leadership of the hospital and Medical
Staff in a different forum. We assembled the
chairman of the board, the president and CEO,
the executive vice president, the vice president of
Medical Affairs, and all the departmental chairs.
2
2
Raul Arguello, M.D. (Pediatrics); Patrick Broderick, M.D. (Emergency Department); Charles Herrick, M.D. (Psychiatry); Ramon Kranwinkel, M.D. (Laboratory); Thorsten Krebs, M.D. (Radiology); Pierre Saldinger, M.D. (Surgery); Martin Serrins, M.D. (Anesthesia); Patricia
Tietjen, M.D. (Medicine). John M. Murphy, M.D. (Exec .VP); Matthew Miller, M.D. (VP Medical Affairs);
John J. Martocci (Chairman of the Board), Frank Kelly, (President and CEO.)
132
The forum encouraged open discussion around these issues:
Patient Care — Quality and Safety
New technology
Studies published recently show that health care quality is
not all it could be. How are the hospital and its medical
staff addressing the quality of care and patient safety?
All technology — information,
equipment, electronics, drugs, and
procedures — changes rapidly. What
is the hospital and the medical staff
doing to insure that we stay at the
forefront and that we make the right
choices?
“At Danbury Hospital, ‘The patient comes first’ is for
real. People here truly care about our patients.”
“We routinely survey and adopt the most valid
measures of health care quality that are constantly
evolving. These measures are increasingly based on
evidence of better outcomes; that patients get better
faster, that care is safer, and that delivery of care is
consistent and more efficient.”
“Our goal is to make our levels of quality and
safety transparent to all. Consumers, encouraged
by insurance companies and Medicare, will become
better informed about quality and will fuel demand
for better and more cost-effective care.”
“Technology and systems already exist to create
records, measure all kinds of data, provide results,
control equipment, monitor rules and performance,
train, assist with decision making and even generate
their own communications.” 3
“We also focus on the hospital’s human ‘systems.’ We
use checklists, create redundancies, conduct practice
drills, review charts and cases, and work to make the
right thing to do the easy thing to do. Our stated
goal is to be completely free of preventable error. We
dedicate specialized resources throughout the hospital
to manage the quality of care and safety.”
3 An electronic system already employed, computerized physician order entry, known as CPOE,
is an example of using technology as a quality tool. With CPOE doctors no longer write orders out longhand, but enter them directly into the system. In addition to preventing handwriting errors, CPOE contains built-in safety and clinical checks for patients against a variety of
possible errors and provides guidance toward standard practices.
“Our choices regarding technology
are based on evidence. We use
evidence that the technology is truly
effective and efficient, not just new.
Sometimes technology gets ahead
of the evidence, but we have much
better data and techniques now to
evaluate such things as equipment,
drugs and procedures.”
“We have lots of ways to
stay current like professional
publications, our involvement
in teaching and research, and
attendance at seminars. Much
new information is automatically
pushed to us electronically.”
“One important way we stay
current involves our role in medical
education and research. As a
teaching hospital we encourage
our doctors’ roles as instructors at
several other academic centers. As
they teach, they learn and bring that
knowledge back to the hospital and
the community. Our own teaching
program also insures that we stay
LOOKING AHEAD 133
Financial soundness
current because you can’t teach and
stand still in your knowledge.”
“We have increased our research
programs to more than 90 per year
and now have launched a major
research initiative that will keep
us pushing at the leading edge of
knowledge.”
New medical equipment and technology costs more than
what it replaces. New procedures often require added staff
and facilities changes. The hospital faces growing demands
but its resources are not unlimited. Reports of hospitals
across the country suffering financial distress appear often
in the press. What is the hospital doing to insure that it
is financially sound and able to make the best decisions
to insure access to quality care for the people in our
communities?
“Bringing onto our staff the
brightest, best-trained people we
can find gives us a big boost in
staying current.”
“The hospital recognized many years ago that it could
not meet all the community’s needs by itself. We
constantly refine our many partnership arrangements,
including philanthropy, to address these challenges.”
“A new technological initiative
called HealthLink typifies our
vision for the electronic future. The
hospital is leading an effort to create
an electronic network that will
interconnect all the health resources
in the community. It will connect
the hospital, doctors’ offices, nursing
homes, pharmacies, laboratories,
home care agencies, government
agencies, and eventually other
hospitals. Patients obtaining care
anywhere will have their complete
and current medical record and
history available to whomever is
providing them care.”
“Growing numbers of people in the community have
favored the hospital by choosing us for care. Our
revenue is strong.”
134
“We employ the performance-improvement techniques
of business, such as measuring ourselves against best
practices and using well-known programs like “Lean
Six” to continually challenge ourselves.”
“The board has committed more than $250 million
toward the vision of the hospital’s future ability to serve
its patients.”
“The board looks at the system and the ways
management is approaching the changing environment.
The focus of the board is to represent the community
and all of the hospital’s key stakeholders and to help the
hospital administration balance the clinical, business
and stewardship pieces of the organization.”
Closing Notes
Frank. J. Kelly / John M. Murphy, M.D.
F
or 125 years Danbury Hospital has faced challenges and has changed
to meet them. Whether they were the internal problems of the 1950s,
the explosive growth of the 1970s or the advent of managed care in the
recent past, the hospital, in its system of partnership with the community
and with its staff of medical professionals and employees, initiated the
changes necessary and continued to fulfill its mission.
The years ahead will be every
bit as dynamic as those of the
past. Consumers will have
access to better information
and therefore will enjoy more
choices and more options for
care. Technology will continue to
drive care to alternative settings
and offer less-invasive procedures.
Patients will be treated with
miniaturized implantable devices.
Molecular medicine will provide
treatment designed specifically
for individual patients based on
their DNA. We will be able to
offer more treatments than ever
before. Sophisticated information
technology will provide safer and
more comprehensive information
to address the most complex cases.
The challenges will be as tough
and as critical as any we have ever
faced. The demand for health care
grows larger every year. The cost of
providing that ever-more expensive
care, if left unchecked, could hinder
our ability to fulfill our mission and
we cannot let that happen. These
challenges call for a new vision
of our health care system and for
Danbury Hospital.
The vision for our new health care
system goes beyond the hospital
facilities and its outpatient locations
and services. HealthLink, for
example, will integrate doctors,
nursing homes, pharmacies,
laboratories, insurance companies,
other hospitals and government
agencies like Medicare. Other
complex and interdependent
technologies will impact how
we care for patients. Based on
evidence, everyone in the system
will employ the best practice of care
for each patient and each condition.
Patients, too, will be invited to take
part in their own care based on
their desire and capability to do so.
The far edge of our vision sees a
time when we focus on managing
health, not just treating illness. The
diabetic who misses an annual eye
exam or the elderly patient who has
not refilled a critical prescription
will attract attention and action.
But these systems cannot manage
themselves and a vision of the future
doesn’t guarantee its reality. In the
end, as it always has, it comes down
to people. The caring, dedicated
people of Danbury Hospital, its
medical staff, and the people in
the community will continue to
initiate change in the face of new
challenges. We will continue to
fulfill our mission.
LOOKING AHEAD 135
Appendix
I. Facts - Accloades - Awards
II. Historical Timeline
III. People in History
IV. Residency Programs
V. Certifications
VI. Satellite Locations
136
I. Danbury Hospital Facts, Accolades and Awards
D
anbury Hospital is a 371-bed
regional medical center and university
teaching hospital associated with
New York Medical College, the Yale
University School of Medicine, the
Connecticut School of Medicine
and Columbia University Medical
Center. The hospital provides centers
of excellence in cardiovascular
services, cancer, weight loss surgery,
orthopedics, digestive disorders,
women’s services and radiology. It also
offers specialized programs for sleep
disorders and asthma management.
Medical staff members are board
certified in their specialties.
Danbury Hospital
is ranked in the top
5 percent of hospitals in
the country for overall
clinical performance for 2009 by
HealthGrades, a leading independent
health care rating organization. It
is the only health care facility in
Connecticut ranked among the top
5 percent of hospitals nationwide for
overall clinical performance five years
in a row.
In the area of cardiac
care, Danbury
Hospital is ranked
number one in
Connecticut for
cardiac surgery for
2009 and in the top
5 percent nationally
for overall cardiac
care by HealthGrades. This is the
second consecutive year for the
national award.
In the area of gastrointestinal
care for 2009, Danbury Hospital
is ranked in the top 5 percent
nationally for overall gastrointestinal
services and gastrointestinal surgery
by HealthGrades. This is the second
consecutive year for the national
award.
In 2009, Danbury
Hospital was ranked
in the top 5 percent
in Connecticut for
the treatment of stroke for a seventh
consecutive year by HealthGrades.
The hospital is a nationally accredited
stroke care center by The Joint
Commission. Danbury Hospital is
also the recipient of the American
Stroke Association’s Get with the
Guidelines-Stroke Silver Performance
Achievement Award for its higher
standard of care.
In the area of orthopedics for 2009,
Danbury Hospital ranks in the top
5 percent in Connecticut for joint
replacement by HealthGrades.
In the area of vascular care,
Danbury Hospital was ranked in the
top 5 percent for 2009 in Connecticut
for vascular surgery for five
consecutive years by HealthGrades.
For 2009, a leader in service
excellence, Danbury Hospital
was ranked in the top 10 percent
nationally for overall patient
satisfaction and in the top 3 percent
in the country for nursing care by
Press Ganey Associates, the industry
leader in health care satisfaction
measurement.
Danbury Hospital received
the 2009/2010 Women’s
Health Excellence Award™ from
HealthGrades, based on a newly
released study of patient outcomes.
This places Danbury Hospital
among the top 5 percent in the
nation for women’s health.
Danbury Hospital is a member of
Danbury Health Systems, Inc. which
also includes: Business Systems, Inc.,
for outpatient pharmacy services;
Danbury Health Care Affiliates,
Inc., for services to business and
industry and emergency medical
services; Regional Hospice of
Western Connecticut, Inc., for care
and support of people with lifelimiting illness; Danbury Visiting
Nurse Association, Inc., for home
care, maternal-child health care and
outreach services; Danbury Offices
of Physicians Services (DOPS), a
multi-specialty medical practice; and
the Danbury Hospital Development
Fund, which raises funds to support
the hospital.
To learn more about Danbury
Hospital or to find a Danbury
Hospital physician, visit us at our
award winning website,
www.danburyhospital.org.
APPENDIX
137
II. Historical Timeline
1885-1910
Chapter 1
1910-1920
Chapter 2
1920-1940
Chapter 3
1940-1950
Chapter 4
1950-1960
Chapter 5
Danbury Hospital opens in two cottages on Crane Street
“New” Victorian building opens – cost is $21,545.98
Nurses Training School created
Medical Staff formally organized
Endowment Fund formed
Hospital reorganizes, separating “Trustees” from “Managers”
60-bed brick building opens (now the Center Building)
Dr. Sophia Penfield becomes the first woman doctor on staff
Annual admissions top 1,000
40-bed East Building opens
New laboratory, X-Ray, one-day surgery added
American College of Surgeons recognizes Danbury as an “Approved Hospital”
North Building nursing quarters opened
John F. Kennedy admitted for appendicitis
60-bed West Building opens
Nurses Training School selected as U.S. Cadet School
Multi-disciplinary clinics formed for children and for cancer
Hospital is war-time penicillin depot
Hospital endures and overcomes internal strife
First wave of board-certified specialist doctors arrives
Medical staff reorganized
Full accreditation restored
Relationships developed with academic centers (Yale, N.Y. Medical College)
Development Fund formed
South Building opened
continued
138
1960-1970
Chapter 6
1970-1980
Chapter 7
1980-1990
Chapter 8
Laboratory, Radiology, Intensive Care upgraded
Residencies created in surgery, radiology, general practice
More specialists and sub-specialists join the hospital staff
Nurse’s Training School closes
Medicare and Title XIX (Medicaid) arrive
Regional Medical Programs, GI Bill provide money to engage doctors for teaching
and research
Position of director medical education created – marks the establishment of Danbury
as a teaching hospital
First full-time employed doctor
Nuclear medicine program internationally recognized
Hospital opens first Emergency Room with full-time physicians
Renal Dialysis Program created
Annual admissions top 10,000 per year
Relationships with Yale School of Medicine and New York Medical
College strengthened
“Cost Commission” (later called Office of Health Care Access)
creates regulatory hurdles
Four-story Diagnostic and Treatment Center opens
Office of Public Health created
Hospital forms sub-specialty departments with full- or part-time
doctors to direct them
Many new clinical programs begin
Residencies formed in Internal Medicine, Dental, and Obstetrics and Gynecology
Position of vice president of medical affairs created
Tower Building constructed
Solar panels installed
First CT Scan machine installed
Regulations increase with DRGs, other state and federal requirements
HMOs take hold
Administrative burdens increase
Nurses’ strike settled quickly
Health care costs rise sharply
continued
APPENDIX
139
II. Historical Timeline continued
1980-1990
Chapter 8
continued
1990-2000
Chapter 9
More care shifts to outpatient setting
Competitive Surgical Center, Sand Pit complex open
Stroock Building constructed
Hospital reorganized, forms parent (Danbury Health Systems) and subsidiaries
Regional emphasis strengthened with expansion of services to surrounding communities
Hospital’s state-of-the-art technology now includes:
• Magnetic Resonance Imaging
• A Special Procedures Room for Angiography and Angioplasty
• Laser Surgical Capabilities
• A Linear Accelerator
• A Level II Trauma Center
• A Neonatal Intensive Care Unit
• Nuclear Cardiology Imaging
• A Cardiac Catheterization Laboratory
Costs continue to rise dramatically
Admissions decline for the first time in response to “managed care”
“Healthy 2000” community needs survey undertaken
Hospital forms many partnerships, accelerating its role as a vital community resource
Seifert and Ford Community Health Center opened
WOW van, patient courtesy van launched
Marcus Cardiac Rehabilitation Center opened
Duracell Ambulatory Surgical Center opened
Praxair Cancer Center opened – a “healing” environment
Emergency Department expanded
700-car garage constructed
Programs for Hospitalists and Intensivists developed
Evidence-based medicine introduced
Focus on measurement of quality, service, and stewardship in pursuit of national
“best practices”
Hospital publishes first performance report card in Connecticut
“Community Benefit” calculated and published
Hospital recognized nationally by U.S. News and World Report - first national recognition
continued
140
2000-2010
Chapter 10
Danbury Hospital sets vision to become a leader in health care delivery and to achieve
national best practices
Danbury Hospital receives numerous national accolades for clinical excellence and patient
safety; Hospital ranked in the top tier of hospitals nationally
Patient-centered care philosophy established, giving rise to “a higher level of care”
Admission volumes resume rise
Centers of Excellence formed
Hospital gains approval for angioplasty and open heart surgery
Praxair Regional Heart and Vascular Center dedicated
Danbury Hospital Medical Arts Center opened, creating outpatient “healing” environment
Hospital designated a Primary Stroke Center
Morganti Center for Wound Care and Hyperbaric Medicine opens
Family Birth Center and Neonatal Intensive Care Unit renovated
Women’s health initiative formed
Stereotactic Radiosurgery introduced
The Carmen Lucia and Peter Buck Center for Robotic Surgery established
Information technology serves to integrate care among providers and patients, including:
• Wireless network
• Computerized Physician Order Entry
• Electronic medical records
• HealthLink community wide electronic health record initiative
Danbury Hospital Children’s Health and Wellness Center opens to provide sub-specialty
pediatric care
New Emergency Department and Bed Tower expansion announced – Vision for
2020 established
Danbury Hospital moves to establish ties with other regional health care organizations to
more broadly execute its mission to improve the health and well being of the community in
partnership with those we serve.
Hospital celebrates
125th anniversary
APPENDIX
141
III. People in History
Directors Serving During Danbury Hospital’s
Growth Years (1970-2009)
Director Years Served
John Allen
Paul A. Amory
Gino Arconti
Digby Barrios
Eduard Baruch
Iris Batson
Ramon Batson, M.D.
John Bees
C. Wendell Bergere, Esq.
Kenneth Berol
Ray Boa
John Borruso, M.D.
Leo Brancato
Marc Breslawsky
Barbara Burgdoerfer
Donald Brush
Albert Casazza, M.D.
Richard Casden, M.D.
William Casey
Thomas Cheney, Esq.
Joseph Cherry , M.D.
William W. Chorske
S. I. Clark
Vincent Colgan
Malcolm Crawford
John C. Creasy
Neil Culligan, M.D.
A. Robert Curcio
David Cyganowski
John C. Daniels, M.D.
M. Dick
Morse Dial Jr., Esq.
John R. Doody
Joan Draper, M.D.
Thomas Draper, M.D.
Joseph Dumser
Richard Durkin
James F. Edwards
Karl H. Epple
Stephen Feldman, Ph.D
Edwin G. Fernand, M.D.
Gerard Foye, M.D.
Charles Frosch
Jack Garamella, Esq.
Robert Geckle
Morley Goldberg, M.D.
Hillel Goldman, Esq.
J. F. Green
James P. Gregory, Esq.
Robert Grossman, M.D. Michael B. Hammond
Benjamin Heyman
John W. Hoffer
Nick Holloway
A. J. Hurley
Richard Jarbara
Lois Jones
G. Dwight Kahlo III
Frank J. Kelly
James Kennedy
C. Robert Kidder
John C. Kline
Michael Kluger
142
1996-2000
1988-1989
1979-1981
1999
1973
1996-1999
1996-2000
1987
1987-1992
1977-1978
2000-2007
2000-2005
1971-1972
1992-1995
1981-1982
1981-1990
1975-1976
1990-1991
1973-1974
1970-1980
1971-1974
1986
1971-1972
1995-2003
1986-1993
1970-1988
2008-2009
1978-1982
2008-2009
1979-1981
1970
1984-1990
1973-1974
2004-2005
1993-1995
1973
1970-1975
1971-1991
1974-2009
1991-1992
1979-1980
1973-1979, 1998-2000
1992
1988-2003
1986-1987
1991-2007
1985
1998-2008
1970
1988-1997
1988-1990
1993-2008
1970-1972
1971-1999
1983-1985
1970
2008-2009
1988-1989
1970-1978
1988-2009
2007-2009
1992-1994
2007-2009
2006-2007
Stephen Korwin, M.D.
David Kramer, M.D.
Thomas Van Lenten, Esq.
Robert Lewis
Jeffery Lichtenstein, M.D.
Joyce C. Ligi
Elinor London
Jack Marcus
Neil Marcus, Esq.
John J. Martocci
Susan Marturlo, M.D.
Horace McDonell
Bessie Montesano, M.D.
Frank T. Morgan
Gail Nordmoe
George O’Brien
James Parkel
John R. Patrick
Mary Patterson
Denise Payne
Charles Perrin
Saul Poliak
Marvin Prince, M.D.
William Prokop
Robert E. Pyle, Ph.D.
Donna Ramey
Gerard D. Robilotti
Perry Roehm
Richard Rubin, M.D.
Rudy Ruggles
Alvin Ruml
Joseph D. Skrzypczak
Stanford Smith
Harry Soletsky, M.D.
Robert Spies
Michael Stavola
Richard Steiner
Sally Stockman
Robert Stockman
Bertrum Stroock
Margaret Stroock
Rita Thal
Rolf J. Thal
Jay Thompson
Barbara Totolis
Gary Townsend, M.D.
Gail O. Troutman
David N. Verner
Jack Villodas
Robert Wallace Theora G. Webb
Jay Weiner, M.D.
R. V. Welty
Robert Wenick, M.D.
Brian C. White
Lucy Wilson
David Zolov, M.D.
1986
2006-2009
1970-1976
1994-1997
1996-2003
2001-2007
1973
1970-1972
1987-2009
2004-2009
1994
1978-1994
2000-2003
1995-2008
1974-1977
1994-1995
1970-1972
1996-2002
2004-2009
1993-1996
1983-1985
1995-1996
1986-1987
1981-1984
1976-1977
1982-1986
1996-1997
1987-1997
1970-1974
1982
1988-1994
1980
2009
1996-2000
1978-1980
1979-1987
1970-1972
1997-1998
1979-1987
1975-1980
1970-1974
1974-1976
1970-1981
1973
1996-1997
1990-1992
1986-1987
1995-2008
2000-2009
1996-1997
1986-1987
1998-1999
1977-1978, 1987
1988-1992
2001-2009
2008-2009
1986-1990
1987-1996
APPENDIX
143
III. People in History continued
Presidents of the Medical Staff at Danbury Hospital
name
year elected
name
year elected
W.C. Wile, M.D.
Nathaniel Selleck, M.D.
E. A. Stratton, M.D.
Samuel F. Mullins, M.D.
H. F. Brownlee, M.D.
Howard D. Moore, M.D.
William M. Stahl, M.D.
D. Chester Brown, M.D.
Nathaniel B. Selleck, M.D.
William A. Sunderland, M.D.
W. Frank Gordon, M.D.
Patricia T. Mcllroy, M.D.
James J. Murphy, M.D.
Robert A. Fox, M.D.
John J. Gaffney, M.D.
John D. Booth, M.D.
Frank M. Goldys, M.D.
Felix F. Tomaino, M.D.
Isadore L. Amos, M.D.
John C. Murphy, M.D.
Louis Rogol, M.D.
Eugene D. Brochu, M.D.
1910
1918
1923
1927
1928
1929
1930
1931
1932
1934
1936
1942
1944
1945
1947
1950
1953
1954
1955
1956
1957
1958
J. Benton Egee, M.D.
Dean H. Edson, M.D.
Victor A. Machcinski, M.D.
Paul Kunkel, M.D.
Fred C. Spannaus, M.D.
Joseph B. Cherry, M.D.
Robert P. Fornshell, M.D.
Nelson A. Gelfman, M.D.
John C. Daniels, M.D.
Edwin G. Fernand, M.D.
Marvin L. Prince, M.D.
Morley M. Goldberg, M.D.
Gary L. Townsend, M.D.
Robert S. Grossman, M.D.
David M. Zolov, M.D.
Thomas F. Draper, M.D.
Jeffrey L. Lichtenstein, M.D.
Robert L. Wenick, M.D.
Joan Draper, M.D.
Robert L. Wenick, M.D.
Neil Culligan, M.D.
1960
1962
1965
1967
1969
1971
1972
1973
1976
1979
1981
1984
1986
1988
1991
1993
1996
1998
2000
2004
2006
2008
Current Executive Team
position
President and Chief Executive Officer
Executive Vice President
Senior Vice President — Chief Financial Officer
Chief Compliance Officer
Chief Information Officer
Vice President —
Operations
SVP Patient Care — Chief Nurse Executive
Vice President Danbury Health Systems
President — Danbury Hospital Development Fund
Vice President — Operations
Senior Vice President — Chief Medical Officer
Vice President —
Quality and Patient Safety
Vice President — Marketing and Planning
Senior Vice President — Human Resources
144
name
years served
Frank J. Kelly
1977 Present
John Murphy, M.D.
2008 Present
William Roe
2009Present
Joseph Campbell
2001Present
Peter Courtway
1973 Present
Michael Daglio
2004 Present
Moreen Donahue
2006 Present
Morris Gross
1975 Present
Catherine Halkett
2007Present
Lisa Messina
1991 Present
Matthew Miller, M.D. 1980 Present
Dawn Myles
1988 Present
Judith Ward
2007Present
Phyllis Zappala
1998 Present
year elected
CEO 1988
Incoming CEO 2010
CIO 1995
VP 2007
SVP 2007
VP 1992
VP 2007
VP 1991
VP 2009
SVP 2007
Department Chairs
Anesthesia
years served
John Daniels, M.D.
Roger Mecca, M.D.
Martin Serrins, M.D.
1971 1983
1983 2005
2005 Present
Behavioral Health
years served
Bernard Strauss, M.D.
Orestes Arcuni, M.D.
Charles Herrick, M.D.
1975 1980
1980 2007
2007 Present
Emergency Medicine
years served
J. Benton Egee, M.D.
Peter Pratt, M.D.
George Terranova, M.D.
Patrick Broderick, M.D.
19651975
19751978
19782002
2002Present
Medicine
Jay Bollet, M.D.
Paul Iannini, M.D.
Patricia Tietjen, M.D.
OB/GYN
19801993
19902008
2008Present
years served
years served
Morley Goldberg, M.D.
George Kleiner, M.D.
Lester Silberman, M.D.
Howard Blanchette, M.D. Richard Ruben, M.D.
19771978
19781982
19822000
2000 2008
2008Present
Pathology
Pediatrics
years served
John Gundy, M.D.
Thomas Draper, M.D.
Jack Fong, M.D.
Raul Arguello, M.D.
19781983
1983 1985
19852008
2008Present
Radiology
years served
William Goldstein, M.D.
Patrick Malloy, M.D.
Thorsten Krebs, M.D.
19681998
19982002
2002Present
Surgery
years served
Phillip Kotch, M.D.
Duane Freier, M.D.
John DeFrance, M.D.
Pierre Saldinger, M.D.
19821986
19871991
19922004
2004Present
Dentistry
years served
Harold Silver, D.D.S.
1956 1974
Howard Glaser, D.D.S.
1974 1977
Andrew Ragona, D.D.S. 1977 1980
Daniel Spinella, D.D.S.
1980 1982
Anthony Cuomo, D.D.S.
1982 1985
Lewis Trusheim, D.M.D. 1985 1997
Stephen Hoffman, D.D.S. 1997 2002
Thomas Kah, D.D.S.
2002 Present
years served
Nilo Herrera, Sr., M.D.
19601990
Ramon Kranwinkel, M.D. 1990Present
APPENDIX
145
IV. Residency Programs
Inception at
Program Sponsor Resident PositionsDanbury
Internal Medicine
Danbury Hospital
42
1976
Pathology
Danbury Hospital
8
1962
Ob/Gyn
Danbury Hospital
12
1978
Dentistry
Danbury Hospital
3
1976
Anesthesiology
Westchester Medical Center
New York Medical College
5
2005
Psychiatry
Westchester Medical Center
5
1983
Surgery
Sound Shore Medical Center
Medical Center
10
1997
6
2005
Cardio Vascular Danbury Hospital Fellowship
146
V. Certifications
The Joint Commission Hospital
Accreditation: 2007-2011
The Joint Commission Primary Stroke
Center Certification: 2008-2010
Department of Public Health Stroke Center
Designation (effective 2007)
Accreditation Council of Graduate Medical
Education (2005-2007)
Laboratory Licenses
Regional Hospice
• State Licensed Home Health Care agency for: Hospice, Nursing, Physical Therapy, Medical Social Work, Occupational Therapy, Speech Therapy, Home-maker, and Home Health Aide
• Medicare Certified for Hospice and Home Care
• Member of the National Hospice and Palliative Care
Organization (NHPCO)
• Member of the Connecticut Association for Home Care
and Hospice (CAHCH)
CLIA(Clinical Laboratory
Improvement Amendments)
CAP
The College of American Pathologists
New York State
Clinical Laboratory Permit
State of Connecticut
Registration and Approval
Blood Collection Facility
Gen Blood Banking Operation
American Association of Blood Banks Accreditation
Point of Care License
CLIA(Clinical Laboratory
Ridgefield Surgicenter: CLIA(Clinical Laboratory
CAP
The College of American Pathologists
• Member of the Foundation for Hospice in Sub-Saharan Africa Partnership Initiative
Vascular Lab:
Accredited Vascular lab in six disciplines by Intersocietal
Commission on Accreditation of Vascular Laboratories
• State licensed for its complete array of services
• Medicare and Medicaid certified.
• Accredited by the Joint Commission (JCAHO)
• Accreditation pending from the Community Health
Accreditation Program (CHAP)
• Recognized as a Home Health Care Elite TOP 500
(top 5% nationally) company for past three years.
• Recognized for success in providing influenza vaccinations from the Connecticut Influenza and Pneumococcal Coalition in 2008,
• State of Connecticut Immunization Action Program award for outstanding results with childhood immunization.
Echocardiography:
Accredited Echocardiography Service in three disciplines by
Intersocietal Commission on Accreditation of Echocardiography
Nuclear Medicine, PET and Nuclear Cardiology:
Accredited Nuclear Medicine services by Intersocietal
Commission on Accreditation of Nuclear Medicine Laboratories
• Accreditation pending from the Community Health
Accreditation Program (CHAP)
• Honorable Mention Recipient, 2008 Family Caregiving Awards, sponsored by The National Alliance for Caregiving and Met Life Foundation
Danbury Visiting Nurse Association
The Danbury VNA was founded in 1911 by Danbury’s first female
physician, Dr. Sophia Penfield. The Danbury VNA provides home
health care visits to patients of all ages in Danbury, Newtown,
New Fairfield, Bethel, Southbury, Woodbury, Redding, Ridgefield
and Brookfield and other Northern Fairfield County towns.
Home Care Services Include:
Skilled Nursing Speech Therapy Physical Therapy Nutrition Therapy Remote Telehealth Monitoring Occupational Therapy Home Health Aid Respiratory Therapy
Medical Social Work Hospital Liaison Services
APPENDIX
147
VI. Danbury Hospital Satellite Locations
DANBURY
Danbury Diagnostic Imaging
20 Germantown Road
Phone: (203) 797-7291
Danbury Hospital
Behavioral Health Services
152 West Street
The Center for Child
and Adolescent Treatment
Services (CCATS) Phone: (203) 830-6082
Children’s Health and
Wellness Center
79 Sand Pit Road
Phone: (203) 739-7380
Seifert & Ford Family
Community Health Center 70 Main Street
Phone: (203) 791-5030
Laboratory Patient Test Center
79 Sand Pit Road
Phone: (203) 739-7306
•
•
The Community Center for Behavioral Health (CCBH)
Phone: (203) 207-5480
Main Street Physical
Rehabilitation Center
235 Main Street
Phone: (203) 730-5900
•
Danbury Hospital
Medical Arts Building
111 Osborne Street
Phone: (203) 739-8200
Danbury Specimen
Collection Facility
41 Germantown Road
Phone: (203) 207-3345
Endocrine and Diabetes
Center of Western Connecticut
25 Germantown Road
Phone: (203) 730-5944
148
Danbury Hospital
Conference Center
79 Sand Pit Road
Phone: (203) 739-7000
Danbury Hospital
Visiting Nurse Association
4 Liberty Street
Phone: (203) 792-4120
Corporate HealthCare/
WorkNET
79 Sand Pit Road
Phone: (203) 749-5720
Primary and Subspecialty
Care Clinics
Phone: (203) 791-5030
Allergy Clinic
Arthritis Clinic
Breast Services Clinic
Endocrine Clinic
HIV Clinic
Neurology Clinic
Orthopedic and Spine Clinic
Podiatry Clinic
Skin Clinic
Urology Clinic
•
Adult Health Center
Phone: (203) 791-5030
•
Community Medicine
Phone: (203) 791-5050
•
Dental Services
Phone: (203) 791-5010
•
Regional Hospice
of Western Connecticut
405 Main Street
Phone: (203) 797-1685
Geriatric Health Center
Phone: (203) 791-5040
•
Pediatric Health Center
Phone: (203) 791-5020
BETHEL
RIDGEFIELD
SOUTHBURY
Danbury Hospital
Business Offices
22 Stony Hill Road
Phone: (203) 730-5800
Ridgefield Diagnostic Imaging
901 Ethan Allen Highway-Route 7
Phone: 203-894-1444
Danbury Hospital
Health Center
22 Old Waterbury Road
Ridgefield Surgical Center
901 Ethan Allen Highway- Route 7
Phone: (203) 244-2400
•
Ridgefield Specimen
Collection Facility
10 South Street
Phone: (203) 431-3776
•
Danbury Hospital
Business Offices
Duracell Berkshire Corporate Park
Phone: (203) 739-7000
BROOKFIELD
Health Specialists
of Southbury
Phone: (203) 262-4270
Southbury Cardio-Vascular Diagnostics
Phone: (203) 262-4234
•
Brookfield Specimen
Collection Facility
Greenknoll Professional Building
60 Old New Milford Road
Phone: (203) 740-3838
Physical Medicine Center
of Southbury
Phone: (203) 262-4230
•
Southbury Geriatrics
Phone: (203) 262-4240
•
Southbury Laboratory
Patient Services Center
Phone: (203) 262-4280
APPENDIX
149
Gross Square Footage by Building and Floor
Bldg.
No.
4
5
6
7
9
10
11
14
15
16
17
18
20
21
22
building
BlueHealthOrangeRedTrailerGold
Name Center East North West South Tower Housing Garage Stroock Ed Ctr Deck MRIGarage (3) Garage DHMAC
Const.
Date
1908
1922
1929
1939
1959/65
1971
1971/
1977
1968
1983
1985/
1997
1985/
1985
1985
1989
1991
2007
Total SF
per Floor
2007
Floor
B
32,216
36,805
28,654
26,618
124,293
1
6,200
12,372
39,777
6,152
62,972
36,704
27,629
43,326
45,465
20,495
301,092
2
10,850
12,915
28,702
5,358
62,972
33,387
3,763
43,136
45,465
20,470
267,018
3
6,972
957
6,031
18,442
29,372
4,201
35,996
6,999
42,546
45,465
20,470
222,292
4
5,561
6,108
8,695
5,592
18,707
29,399
34,194
5,824
1,414
158,040
5
5,561
3,917
7,724
5,592
14,195
23,799
10,244
6,231
77,263
6
5,561
3,917
5,616
5,506
10,846
14,999
1,869
1,597
49,911
7
208
3,944
5,616
5,601
10,882
21,064
47,315
489
309
3,439
1,455
21,064
26,756
632
21,064
21,696
10
21,064
21,064
11
21,064
21,064
12
21,064
21,064
13
12,159
12,159
8
9
Total
SF per Bldg.
150
23,863 19,332
27,960
48,811 100,446 336,807
15,711 125,944 189,199 24,414
27,629
4,841
4,841
42,546
200,208
1,414
163,013 61,435 1,371,027
17-5/16 IN. TOTAL TRIM WIDTH
MAGENTA LINES FOR ART POSITIONING ONLY - DO NOT PRINT
1885
•
2010
10 IN
TRIM
HEIGHT
1885•2010
8-1/2 IN BACK
5/16 IN SPINE
C. D. Peterson
8-1/2 IN FRONT

Challenge and Change

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